# VILLAGE PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1639638489
- **Authorized official:** TAM COTTON (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (503) 389-5754

## Contact information

- **Practice address:** 8430 SW 22ND AVE, PORTLAND, OR 97219-2856
- **Practice address phone:** (503) 389-5754
- **Practice address fax:** (503) 966-1459
- **Mailing address:** 3521 SW COMUS ST, PORTLAND, OR 97219-7561
- **Mailing address phone:** (503) 389-5754
- **Mailing address fax:** (503) 966-1459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2019
- **Last updated:** 09/15/2025