Provider Demographics
NPI:1013908169
Name:H & P GOODELL, INC.
Entity Type:Organization
Organization Name:H & P GOODELL, INC.
Other - Org Name:GOODELL PHYSICAL THERAPY & FITNESS TRAINING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:PURDIN
Authorized Official - Last Name:GOODELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:503-292-5882
Mailing Address - Street 1:4475 SW SCHOLLS FERRY RD
Mailing Address - Street 2:SUITE 258
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1955
Mailing Address - Country:US
Mailing Address - Phone:503-292-5882
Mailing Address - Fax:503-292-5899
Practice Address - Street 1:4475 SW SCHOLLS FERRY RD
Practice Address - Street 2:SUITE 258
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1955
Practice Address - Country:US
Practice Address - Phone:503-292-5882
Practice Address - Fax:503-292-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3705261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy