Jordan Craig Prunty, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

65742 Issued in OR

Practice address

11105 SW Greenburg Rd
Tigard, OR 97223-5446

Phone

(971) 294-2669

NPI assigned

Jun 27, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Neuro Therapy

  • Physical Therapist
  • Tigard, OR
  • NPI 1316394083
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1992693808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11489 SW GABRIEL ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972244062",
            "telephone_number": "971-777-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11105 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235446",
            "telephone_number": "971-294-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNTY",
        "first_name": "JORDAN",
        "middle_name": "CRAIG",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Health & Services - Oregon
• Providence Health & Services - Oregon
• Providence Health & Services Oregon
• Providence Health & Services Oregon
• Providence Health & Services Oregon
• Psychology & Wellness Group PDX LLC
• Puget Sound Medical
• Tyler W. Pundt
• Corey Pursel
• Brian L Puskas, MD

• Physical Therapist in Tigard, OR
• Providers in Tigard, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.