# BODYWISE PHYSICAL THERAPY INC

> 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:** 1629021290
- **Authorized official:** MEGAN MARIE MOSELEY PT, LMT (PRESIDENT/OWNER)
- **Authorized official phone:** (503) 701-4390

## Contact information

- **Practice address:** 1030 NW 12TH AVE STE 1, PORTLAND, OR 97209-2838
- **Practice address phone:** (503) 701-4390
- **Practice address fax:** (503) 974-2612
- **Mailing address:** 1030 NW 12TH AVE STE 1, PORTLAND, OR 97209-2838
- **Mailing address phone:** (503) 701-4390
- **Mailing address fax:** (503) 974-2612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 0829199-3 | OR | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 12/13/2016