# BENCHMARK PHYSICAL THERAPY OF OR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BenchMark PT - Lake Oswego
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184143653
- **Authorized official:** KEVIN JOHANNESON (VP REVENUE CYCLE)
- **Authorized official phone:** (423) 238-7217

## Contact information

- **Practice address:** 440 1ST ST, LAKE OSWEGO, OR 97034-3123
- **Practice address phone:** (503) 744-4826
- **Practice address fax:** (503) 744-4828
- **Mailing address:** 6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
- **Mailing address phone:** (423) 238-7217
- **Mailing address fax:** (423) 238-3473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 09/15/2017
- **Last updated:** 09/15/2017