# LIFESTYLES PHYSICAL THERAPY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013156603
- **Authorized official:** KELLY STOTT CAMPBELL PT (PRESIDENT)
- **Authorized official phone:** (503) 235-3386

## Contact information

- **Practice address:** 4445 SW BARBUR BLVD., SUITE 204, PORTLAND, OR 97239
- **Practice address phone:** (503) 235-3386
- **Practice address fax:** (503) 239-1694
- **Mailing address:** 4445 SW BARBUR BLVD., SUITE 204, PORTLAND, OR 97239
- **Mailing address phone:** (503) 235-3386
- **Mailing address fax:** (503) 239-1694

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 1369712-7 | OR | Yes |

## Other

- **Enumeration date:** 02/05/2009
- **Last updated:** 10/02/2014