Provider Demographics
NPI:1861865776
Name:POWERED BY MOTION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:POWERED BY MOTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:COCHRUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:503-708-7030
Mailing Address - Street 1:29099 SW COURTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6463
Mailing Address - Country:US
Mailing Address - Phone:503-708-7030
Mailing Address - Fax:
Practice Address - Street 1:5167 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-5349
Practice Address - Country:US
Practice Address - Phone:503-708-7030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR605882251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty