Provider Demographics
NPI:1205905932
Name:TWEET, MONICA (PT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:TWEET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 SW BRIDGEPORT RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7707
Mailing Address - Country:US
Mailing Address - Phone:503-620-2400
Mailing Address - Fax:503-620-2410
Practice Address - Street 1:7421 SW BRIDGEPORT RD
Practice Address - Street 2:SUITE 215
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7711
Practice Address - Country:US
Practice Address - Phone:503-620-2400
Practice Address - Fax:503-620-2410
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR132390Medicare ID - Type Unspecified