Organization
STOUT PERFORMANCE AND PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE STOUT (OWNER/PROVIDER)
(503) 949-1727
Entity
Organization
Contact information
Practice address
710 NE HOLLADAY ST # 150, PORTLAND, OR 97232-2168
(503) 542-2744
Mailing address
710 NE HOLLADAY ST # 150, PORTLAND, OR 97232-2168
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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