Organization
BEATA MORENO, PT PC
Active
Other names
Beata Moreno, PT PC, Holistic Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BEATA MORENO P.T. (PRESIDENT)
(503) 246-8282
Entity
Organization
Contact information
Practice address
4031 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5243
(503) 246-8282
(503) 231-6605
Mailing address
4031 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5243
(503) 246-8282
(503) 231-6605
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3976
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116217
MEDICARE GROUP NUMBER
OR
Enumeration date
07/02/2006
Last updated
03/26/2013
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