# STARGAIT PORTLAND PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1275129777
- **Authorized official:** ANGELA ZIELINSKI PT, DPT (COO)
- **Authorized official phone:** (971) 219-4899

## Contact information

- **Practice address:** 8354 SW NIMBUS AVE, BEAVERTON, OR 97008-6444
- **Practice address phone:** (971) 219-4899
- **Practice address fax:** (855) 840-8203
- **Mailing address:** 5054 SE INA AVE, PORTLAND, OR 97267-5927
- **Mailing address phone:** (971) 219-4899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/18/2020
- **Last updated:** 12/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 500689137 | — | OR |
| 05 | — | 50077834 | — | OR |