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Organization
AS YOU AGE
Active
Organization
AS YOU AGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PIDKOWICZ OT (OWNER)
(661) 714-4178
Entity
Organization
Contact information
Practice address
17371 SW GALEWOOD DR, SHERWOOD, OR 97140-7912
(503) 482-8502
Mailing address
6107 SW MURRAY BLVD # 479, BEAVERTON, OR 97008-4421
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225XE0001X
Environmental Modification Occupational Therapist
Primary
—
NULL
225XE0001X
Environmental Modification Occupational Therapist
Primary
—
—
Other
Enumeration date
07/10/2026
Last updated
07/10/2026
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