Jeffery Alan Brooks, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Wilsonville, OR
NPI 1992997381 · NPPES record last updated Aug 9, 2007
Key facts
- NPI
- 1992997381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT00006813 (WA)
- Practice address
- 25117 SW Parkway Ave
Suite D
Wilsonville, OR 97070-9697 - Phone
- (503) 570-3665
- Fax
- (503) 570-9155
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 1809 | ID | MD | Physical Therapist |
| PT00006813 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synergy Healthcare Inc. | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00006813 | WA | Yes |
| Physical Therapist | 225100000X | PT 1809 | ID |
Addresses
Primary practice location
25117 SW Parkway Ave
Suite D
Wilsonville, OR 97070-9697
Mailing address
4813 S Low Way CT
Spokane Valley, WA 99206-9444
Phone (509) 370-0645
Other providers in Wilsonville, OR
- Alexandra Braun
- Ryan Bridges
- Brittany Samantha Brockman
- Brookdale Hospice, LLC
- Brittney Brookfield
- Addison McKenna Alexys Brown
- Brooke Brown
- Joyce Wangsgard Brown
- Caitlin Ashley Bruns
- Rachael Alana Bubeck
All providers in Wilsonville, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.