Provider Demographics
NPI:1558308478
Name:NEW HEIGHTS INTEGRATIVE THERAPY INC
Entity Type:Organization
Organization Name:NEW HEIGHTS INTEGRATIVE THERAPY INC
Other - Org Name:NEW HEIGHTS PHYSICAL THERAPY PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:POE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-236-3108
Mailing Address - Street 1:5736 NE GLISAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3750
Mailing Address - Country:US
Mailing Address - Phone:503-236-3108
Mailing Address - Fax:503-236-3239
Practice Address - Street 1:5736 NE GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3750
Practice Address - Country:US
Practice Address - Phone:503-236-3108
Practice Address - Fax:503-236-3239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR103394Medicare ID - Type Unspecified