# PT NORTHWEST LLC

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

## Provider details

- **NPI number:** 1417934886
- **Authorized official:** KENNEDY I HAWKINS (PRESIDENT GENERAL MANAGER)
- **Authorized official phone:** (503) 540-8701

## Contact information

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

## Taxonomy

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

## Other

- **Enumeration date:** 12/28/2005
- **Last updated:** 06/12/2013