Provider Demographics
NPI:1295908978
Name:MECHANICAL DIAGNOSIS AND THERAPY OF PORTLAND, PC
Entity type:Organization
Organization Name:MECHANICAL DIAGNOSIS AND THERAPY OF PORTLAND, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RINARD
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:503-244-6232
Mailing Address - Street 1:9700 SW CAPITOL HWY STE 140
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5274
Mailing Address - Country:US
Mailing Address - Phone:503-244-6232
Mailing Address - Fax:503-296-2305
Practice Address - Street 1:9700 SW CAPITOL HWY STE 140
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5274
Practice Address - Country:US
Practice Address - Phone:503-244-6232
Practice Address - Fax:503-296-2305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4192225100000X
OR1013560225X00000X
OR56232251X0800X
OR3789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty