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Individual

MR. KARL JAMES KOLBECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1515 NW 18TH AVE, PORTLAND, OR 97209-2516
(503) 228-1306
(503) 228-1307
Mailing address
25 NW 23RD PL, STE 6 - 311, PORTLAND, OR 97210-5580
(503) 913-4450
(866) 866-1976

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2675
OR
225100000X
Physical Therapist
4199
WI
225100000X
Physical Therapist
PT00005973
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158552
OR
Enumeration date
01/09/2006
Last updated
06/18/2012
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