Provider Demographics
NPI:1972705986
Name:SHORT, ARIN (MPT)
Entity Type:Individual
Prefix:MR
First Name:ARIN
Middle Name:
Last Name:SHORT
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 SW REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7187
Mailing Address - Country:US
Mailing Address - Phone:503-216-0048
Mailing Address - Fax:
Practice Address - Street 1:6640 SW REDWOOD LN
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97224-7187
Practice Address - Country:US
Practice Address - Phone:503-639-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4184225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist