Provider Demographics
NPI:1356410054
Name:GENTLE STEPS CHILDREN'S THERAPY CENTER
Entity type:Organization
Organization Name:GENTLE STEPS CHILDREN'S THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-640-3803
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-1568
Mailing Address - Country:US
Mailing Address - Phone:503-640-3803
Mailing Address - Fax:503-640-3805
Practice Address - Street 1:403 SW DENNIS AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-3928
Practice Address - Country:US
Practice Address - Phone:503-640-3803
Practice Address - Fax:503-640-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR006341261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy