Provider Demographics
NPI:1104080373
Name:EVERYBODY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:EVERYBODY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
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:97210-3443
Mailing Address - Country:US
Mailing Address - Phone:503-224-1947
Mailing Address - Fax:
Practice Address - Street 1:1306 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2919
Practice Address - Country:US
Practice Address - Phone:360-314-2384
Practice Address - Fax:360-433-9530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:602839600
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-16
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602839600261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy