Provider Demographics
NPI:1346917739
Name:ASCENDING THERAPY GROUP
Entity Type:Organization
Organization Name:ASCENDING THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GERHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-841-9559
Mailing Address - Street 1:4231 NE 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-3234
Mailing Address - Country:US
Mailing Address - Phone:503-841-9559
Mailing Address - Fax:
Practice Address - Street 1:4231 NE 66TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-3234
Practice Address - Country:US
Practice Address - Phone:503-841-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health