Organization
CLACKAMAS SPORTSCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN BENJAMIN COLLIER DPT (DOCTOR PHYSICAL THERAPY DIRECTOR)
(503) 794-0103
Entity
Organization
Contact information
Practice address
10121 SE SUNNYSIDE RD, SUITE 208, CLACKAMAS, OR 97015-5750
(503) 794-0103
(503) 794-0104
Mailing address
10121 SE SUNNYSIDE RD, SUITE 208, CLACKAMAS, OR 97015-5750
(503) 794-0103
(503) 794-0104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
07/01/2015
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