# ACTIVE EDGE PHYSICAL THERAPY & SPORTS MEDICINE P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ACTIVE EDGE PHYSICAL THERAPY & SPORTS MEDICINE P.C.
- **Other names:** Active EDGE Physical Therapy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912574906
- **Legal business name:** ACTIVE EDGE PHYSICAL THERAPY & SPORTS MEDICINE P.C.
- **Authorized official:** DANIEL C MORLAN PT (PRESIDENT)
- **Authorized official phone:** (503) 387-5449

## Contact information

- **Practice address:** 11000 SW 11TH ST STE 440B, BEAVERTON, OR 97005-4107
- **Practice address phone:** (503) 387-5449
- **Practice address fax:** (503) 342-6846
- **Mailing address:** 2020 8TH AVE STE D, WEST LINN, OR 97068-4657
- **Mailing address phone:** (503) 387-5449
- **Mailing address fax:** (503) 342-6846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2021
- **Last updated:** 06/08/2021