# ELITE PERFORMANCE PHYSICAL THERAPY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1225412927
- **Authorized official:** JESSIE ROBERTS DPT (OWNER)
- **Authorized official phone:** (503) 708-6941

## Contact information

- **Practice address:** 22695 S UPPER HIGHLAND RD, BEAVERCREEK, OR 97004-9732
- **Practice address phone:** (503) 708-6941
- **Mailing address:** 19146 S MOLALLA AVE STE A, OREGON CITY, OR 97045-7167
- **Mailing address phone:** (503) 974-0048
- **Mailing address fax:** (503) 974-0069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 04620 | OR | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/13/2015
- **Last updated:** 01/16/2024