Provider Demographics
NPI:1851725865
Name:WEBINGER, PATRICK (DPT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:WEBINGER
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 1:16126 SE HAPPY VALLEY TOWN CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-4256
Mailing Address - Country:US
Mailing Address - Phone:503-427-0118
Mailing Address - Fax:503-427-0279
Practice Address - Street 1:16126 SE HAPPY VALLEY TOWN CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-4256
Practice Address - Country:US
Practice Address - Phone:503-427-0118
Practice Address - Fax:503-427-0279
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500663726Medicaid
ORR172103Medicare PIN