Northwest Rehabilitation Associates, Inc.
Organization Active NPI Physical Therapy Clinic/Center · West Salem, OR
NPI 1972505790 · NPPES record last updated Dec 6, 2023
Key facts
- NPI
- 1972505790
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- NORTHWEST REHABILITATION ASSOCIATES, INC.
- Practice address
- 1025 2ND St. NW.
West Salem, OR 97304 - Phone
- (503) 371-0779
- Fax
- (503) 371-0886
- NPI assigned
- Aug 11, 2005
- Organization subpart
- No
Authorized official
- Name
- Bobby Ismail
- Title
- President
- Phone
- (093) 531-9882
Practitioners 60
-
Maryssa Leighanne Becker, PT, DPT
-
Victoria Boechler, PT, DPT
-
Grant Andrew Bortnem, DPT
-
Christine Chong, OTD, OTR/L
-
Gillian Corryn Cooper, PT, DPT
-
Kelly L. Domeyer, PT
-
Mason Fessler, PT, DPT
-
John Douglas Giles, DPT
-
Melody Hansen, PT, DPT
-
Craig D Hawkins, PT
-
Marie M. Hook, OTR
-
Zebuli Kiggins, PT, DPT
-
Yiping Lim, PT, DPT
-
Brenda Marie Long, OTR/L
-
Erin L. McMullen, PT
-
Shelly Jo Mendoza, SLP
-
Kate Menke, PT, DPT
-
Harli Nagel, PT, DPT, LAT, ATC
-
Nathaniel Paredes, PT, DPT
-
Christian Phillips, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050111000263 | OR | Part B Supplier - Clinic/Group Practice | 5991753592 |
Receives reassigned benefits from 43 practitioners Practice locations: Salem, OR; Dallas, OR; Keizer, OR |
National Provider Directory
Locations
3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779
3220 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 2706 | OR | |
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X | |||
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
1025 2ND St. NW.
West Salem, OR 97304
Mailing address
3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779
Other practice location 1
3220 Liberty Rd S
Salem, OR 97302-4560
Phone (503) 371-0779
Other practice location 2
3270 Liberty Rd S
Salem, OR 97302-4560
Phone (503) 371-0779
Other providers in West Salem, OR
All providers in West Salem, OR · Physical Therapy Clinic/Center in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.