# TABOR PEDIATRIC PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1487112553
- **Authorized official:** EMILY LOUISE LIGHTHIPE DPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (503) 522-1359

## Contact information

- **Practice address:** 2224 SE 53RD AVE, PORTLAND, OR 97215-3916
- **Practice address phone:** (503) 522-1359
- **Mailing address:** 2224 SE 53RD AVE, PORTLAND, OR 97215-3916
- **Mailing address phone:** (503) 522-1359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/07/2019
- **Last updated:** 03/07/2019