Individual
PETER THOMAS DILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1307 NE 102ND AVE, SUITE G, PORTLAND, OR 97220-3980
(503) 253-0924
(503) 256-5469
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
6524
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500635534
—
OR
01
—
P01106221
RR MEDICARE
—
01
—
P01417734
RR MEDICARE PTAN
OR
Enumeration date
06/03/2011
Last updated
03/23/2015
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