Individual
CHAD DYBDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
702 SW RAMSEY AVE, STE. 220, GRANTS PASS, OR 97527-5858
(541) 479-0765
(541) 479-3461
Mailing address
16083 SW UPPER BOONES FERRY RD, STE. 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5509
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0226042
WASHINGTON L & I
OR
05
—
278901
—
OR
01
—
P00802462
RR MEDICARE
OR
Enumeration date
11/01/2007
Last updated
11/02/2012
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