Provider Demographics
NPI:1336121474
Name:BENSON, AUBREE JANE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:AUBREE
Middle Name:JANE
Last Name:BENSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:AUBREE
Other - Middle Name:JANE
Other - Last Name:SWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
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 1:4040 NE FREMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1952
Practice Address - Country:US
Practice Address - Phone:503-493-4463
Practice Address - Fax:503-493-4348
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR298804Medicaid
OR298804Medicaid