Individual
JACK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5465 SW WESTERN AVE STE H, BEAVERTON, OR 97005-4179
(503) 610-9281
Mailing address
5465 SW WESTERN AVE STE H, BEAVERTON, OR 97005-4179
(503) 610-9281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64087
OR
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/18/2021
Last updated
03/06/2025
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