Provider Demographics
NPI:1033313697
Name:HOUCHENS, AMY J (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:HOUCHENS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16083 SW UPPER BOONES FERRY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7736
Mailing Address - Country:US
Mailing Address - Phone:800-219-8835
Mailing Address - Fax:503-639-9699
Practice Address - Street 1:413 NW LARCH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1361
Practice Address - Country:US
Practice Address - Phone:541-923-7494
Practice Address - Fax:541-504-9153
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2014-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OR5894225100000X
WI5536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500605377Medicaid
ORP01216096OtherRR MEDICARE
ORR155106Medicare PIN