Provider Demographics
NPI:1679684831
Name:DORRINGTON, MICHAEL K (DPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:K
Last Name:DORRINGTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16083 SW UPPER BOONES FERRY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7736
Mailing Address - Country:US
Mailing Address - Phone:503-443-6156
Mailing Address - Fax:503-639-9699
Practice Address - Street 1:4876 NW BETHANY BLVD
Practice Address - Street 2:SUITE3 L-1
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-9259
Practice Address - Country:US
Practice Address - Phone:503-443-6156
Practice Address - Fax:503-639-9699
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5184225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR240066Medicaid
ORR165443OtherMEDICARE
ORR166480OtherMEDICARE
ORR165443Medicare PIN
ORR166480Medicare PIN
OR166478Medicare PIN
ORR166477Medicare PIN
ORR165443OtherMEDICARE
ORR166479Medicare PIN