Provider Demographics
NPI:1093250375
Name:SHEETS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SHEETS PHYSICAL THERAPY LLC
Other - Org Name:SHEETS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:503-819-7526
Mailing Address - Street 1:15333 SE OGDEN DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-7860
Mailing Address - Country:US
Mailing Address - Phone:503-819-7526
Mailing Address - Fax:503-296-2347
Practice Address - Street 1:15333 SE OGDEN DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-7860
Practice Address - Country:US
Practice Address - Phone:503-819-7526
Practice Address - Fax:503-296-2347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2817225100000X
WA00006487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty