Provider Demographics
NPI:1740391093
Name:ZYMKOWITZ, ANNE CARLIN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:CARLIN
Last Name:ZYMKOWITZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:CARLIN
Other - Last Name:RIPLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3634 NE 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1415
Mailing Address - Country:US
Mailing Address - Phone:503-229-4365
Mailing Address - Fax:
Practice Address - Street 1:3600 N INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1106
Practice Address - Country:US
Practice Address - Phone:503-331-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist