# BEND PHYSICAL THERAPY ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TAI Central Oregon Athletic Club of Bend
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144206517
- **Authorized official:** MR. TODD ROBERT GIFFORD PT (COO)
- **Authorized official phone:** (800) 219-8835

## Contact information

- **Practice address:** 61615 ATHLETIC CLUB DR, BEND, OR 97702-3124
- **Practice address phone:** (541) 382-7890
- **Practice address fax:** (541) 382-7498
- **Mailing address:** 11481 SW HALL BLVD, STE 201, PORTLAND, OR 97223-8403
- **Mailing address phone:** (800) 219-8835
- **Mailing address fax:** (503) 639-9699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 12/19/2005
- **Last updated:** 09/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 197670363 | OWCP | OR |