Provider Demographics
NPI:1629052576
Name:DOWD, DAVID SCOTT (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:DOWD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:SHULMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11481 SW HALL BV STE 201
Mailing Address - Street 2:THERAPEUTIC ASSOCIATES INC
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8403
Mailing Address - Country:US
Mailing Address - Phone:800-219-8835
Mailing Address - Fax:503-443-1402
Practice Address - Street 1:4242 COMMERCE SUITE A
Practice Address - Street 2:TAI WEST EUGENE PHYSICAL THERAPY
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5418
Practice Address - Country:US
Practice Address - Phone:541-484-9632
Practice Address - Fax:541-484-7466
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4923225100000X
CA28145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR277958Medicaid
OR277958Medicaid