Provider Demographics
NPI:1629405717
Name:JAMES, MARKI M (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:MARKI
Middle Name:M
Last Name:JAMES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MRS
Other - First Name:MARKI
Other - Middle Name:M
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11203 SE SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7787
Mailing Address - Country:US
Mailing Address - Phone:503-698-5500
Mailing Address - Fax:503-698-5501
Practice Address - Street 1:11203 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-7787
Practice Address - Country:US
Practice Address - Phone:503-698-5500
Practice Address - Fax:503-698-5501
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR05229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist