# FOUNDATIONS PEDIATRIC THERAPY, LLC

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

## Provider details

- **NPI number:** 1699325530
- **Authorized official:** DANIEL A QUINN PT (OWNER / PHYSICAL THERAPIST)
- **Authorized official phone:** (971) 236-3036

## Contact information

- **Practice address:** 4305 SE MILWAUKIE AVE, PORTLAND, OR 97202-3960
- **Practice address phone:** (971) 236-3036
- **Practice address fax:** (877) 335-7643
- **Mailing address:** PO BOX 22406, MILWAUKIE, OR 97269-2406
- **Mailing address phone:** (971) 236-3036
- **Mailing address fax:** (877) 335-7643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 09/12/2019
- **Last updated:** 09/12/2019