Provider Demographics
NPI:1437910833
Name:CENTERED HEALTH PHYSICAL THERAPY AND PILATES LLC
Entity Type:Organization
Organization Name:CENTERED HEALTH PHYSICAL THERAPY AND PILATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIX
Authorized Official - Middle Name:
Authorized Official - Last Name:SKLAREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-208-3779
Mailing Address - Street 1:2051 N ROSA PARKS WAY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-4939
Mailing Address - Country:US
Mailing Address - Phone:774-208-3779
Mailing Address - Fax:
Practice Address - Street 1:825 NE 20TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2275
Practice Address - Country:US
Practice Address - Phone:774-208-3779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy