Provider Demographics
NPI:1194822460
Name:PICK, GREGORY F (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:F
Last Name:PICK
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Other - First Name:
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Mailing Address - Street 1:16083 SW UPPER BOONES FERRY RD
Mailing Address - Street 2:STE 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 1:1325 WAVERLY DR SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-6946
Practice Address - Country:US
Practice Address - Phone:541-967-1224
Practice Address - Fax:541-967-2750
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OR4372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR182545Medicaid
ORR189803Medicare PIN
OR182545Medicaid