Provider Demographics
NPI:1225278682
Name:BEYOND THE CLINIC PC
Entity Type:Organization
Organization Name:BEYOND THE CLINIC PC
Other - Org Name:DOORSTEP THERAPY PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PASTERNAK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MPT
Authorized Official - Phone:503-496-0385
Mailing Address - Street 1:PO BOX 22499
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97269
Mailing Address - Country:US
Mailing Address - Phone:503-496-0385
Mailing Address - Fax:503-496-0787
Practice Address - Street 1:14880 SW SUNRISE LN
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-1255
Practice Address - Country:US
Practice Address - Phone:503-496-0385
Practice Address - Fax:503-496-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR146351Medicare PIN