Provider Demographics
NPI:1477084549
Name:PHYSIO PDX LLC
Entity Type:Organization
Organization Name:PHYSIO PDX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:STUHR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:503-847-8550
Mailing Address - Street 1:2250 NW FLANDERS ST STE G1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3475
Mailing Address - Country:US
Mailing Address - Phone:503-847-8550
Mailing Address - Fax:971-213-4030
Practice Address - Street 1:2250 NW FLANDERS ST STE G1
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3475
Practice Address - Country:US
Practice Address - Phone:503-847-8550
Practice Address - Fax:971-213-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60490261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy