# GATEWAY PARKROSE SPORTS CARE PT LLC

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

## Provider details

- **NPI number:** 1982748141
- **Authorized official:** JOSEPH J FRICKE PT (OWNER)
- **Authorized official phone:** (503) 257-9881

## Contact information

- **Practice address:** 10748 NE HALSEY ST, PORTLAND, OR 97220
- **Practice address phone:** (502) 257-9881
- **Practice address fax:** (503) 257-8964
- **Mailing address:** 10748 NE HALSEY ST, PORTLAND, OR 97220-3961
- **Mailing address phone:** (502) 257-9881
- **Mailing address fax:** (503) 257-8964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 1660 | OR | Yes |

## Other

- **Enumeration date:** 02/19/2007
- **Last updated:** 09/07/2018