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Organization

PT NORTHWEST LLC

Active
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Organization

PT NORTHWEST LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNEDY I HAWKINS (PRESIDENT GENERAL MANAGER)
(503) 540-8701
Entity
Organization

Contact information

Practice address
685 36TH AVE NE, SALEM, OR 97301-0005
(503) 371-8860
(503) 371-9299
Mailing address
685 36TH AVE NE, SALEM, OR 97301-4741
(503) 540-8701
(503) 371-8772

Taxonomy

Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL

Other

Enumeration date
12/28/2005
Last updated
06/12/2013
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