# IPA PHYSIO PORTLAND LLC

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

## Provider details

- **NPI number:** 1063921187
- **Authorized official:** KRISTIN FOSTER (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (503) 616-0313

## Contact information

- **Practice address:** 7412 SW BEAVERTON HILLSDALE HWY STE 110, PORTLAND, OR 97225-2167
- **Practice address phone:** (503) 616-0313
- **Mailing address:** 7412 SW BEAVERTON HILLSDALE HWY STE 110, PORTLAND, OR 97225-2167
- **Mailing address phone:** (503) 616-0313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | 05926 | OR | Yes |

## Other

- **Enumeration date:** 09/20/2017
- **Last updated:** 02/20/2025