# CONNECT PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1023386257
- **Authorized official:** DIANE O. SHIFFER (OWNER)
- **Authorized official phone:** (503) 974-9078

## Contact information

- **Practice address:** 12540 SW 68TH AVE, TIGARD, OR 97223-8597
- **Practice address phone:** (503) 974-9078
- **Practice address fax:** (503) 974-9083
- **Mailing address:** 12540 SW 68TH AVE, TIGARD, OR 97223-8597
- **Mailing address phone:** (503) 974-9078
- **Mailing address fax:** (503) 974-9083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 1330 | OR | Yes |

## Other

- **Enumeration date:** 12/02/2011
- **Last updated:** 05/30/2023