Provider Demographics
NPI:1326154469
Name:GILROY, JOAN KATHLEEN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:KATHLEEN
Last Name:GILROY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:JOAN
Other - Middle Name:KATHLEEN
Other - Last Name:NIEMEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:15224 SW EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007
Mailing Address - Country:US
Mailing Address - Phone:503-579-9114
Mailing Address - Fax:
Practice Address - Street 1:335 SE 8TH AVE
Practice Address - Street 2:TUALITY COMMUNITY HOSPITAL
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97007
Practice Address - Country:US
Practice Address - Phone:503-681-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist