Provider Demographics
NPI:1346672797
Name:THERAPYDIA, INC.
Entity Type:Organization
Organization Name:THERAPYDIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:NOTTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-533-4863
Mailing Address - Street 1:18 E BLITHEDALE AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1908
Mailing Address - Country:US
Mailing Address - Phone:415-533-4863
Mailing Address - Fax:
Practice Address - Street 1:2808 E. BURNSIDE STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214
Practice Address - Country:US
Practice Address - Phone:415-533-4863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy