Organization
THERAPEUTIC ASSOCIATES, INC
Active
Other names
Therapeutic Associates - Sutherlin Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TODD ROBERT GIFFORD PT (COO)
(503) 443-6156
Entity
Organization
Contact information
Practice address
145 MYRTLE ST, SUITE 106, SUTHERLIN, OR 97479-9113
(541) 459-8459
(541) 459-4393
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(503) 443-6156
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0334539
WA L&I
OR
01
—
CG0694
RR MEDICARE
OR
01
—
CG5282
RR MEDICARE
OR
Enumeration date
08/01/2007
Last updated
10/25/2016
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