Provider Demographics
NPI:1134233877
Name:NORTH PACIFIC PHYSICAL THERAPY LTD
Entity type:Organization
Organization Name:NORTH PACIFIC PHYSICAL THERAPY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:503-255-7223
Mailing Address - Street 1:11500 NE 76TH ST STE A3
Mailing Address - Street 2:PMB 7
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-3901
Mailing Address - Country:US
Mailing Address - Phone:360-254-3663
Mailing Address - Fax:360-254-3719
Practice Address - Street 1:10201 SE MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2937
Practice Address - Country:US
Practice Address - Phone:503-255-7223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
054984000OtherBLUE CROSS
OR247270Medicaid
R0000WFBBKMedicare ID - Type Unspecified