Provider Demographics
NPI:1891805776
Name:EVERYBODY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:EVERYBODY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HUGHBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:503-224-1947
Mailing Address - Street 1:2250 NW FLANDERS ST
Mailing Address - Street 2:SUITE GARDEN 01
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:503-224-1947
Mailing Address - Fax:503-274-9530
Practice Address - Street 1:2250 NW FLANDERS ST
Practice Address - Street 2:SUITE GARDEN 01
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3443
Practice Address - Country:US
Practice Address - Phone:503-224-1947
Practice Address - Fax:503-274-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR131602OtherPTAN