Organization
TAI WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD GIFFORD (CEO)
(800) 219-8835
Entity
Organization
Contact information
Practice address
20540 NW EVERGREEN PKWY, HILLSBORO, OR 97124-7111
(503) 671-3962
(503) 671-3922
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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