Provider Demographics
NPI:1649253592
Name:FLEMING, ROBERT WILLIAM (MPT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3786 SW HALL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2050
Mailing Address - Country:US
Mailing Address - Phone:503-626-6587
Mailing Address - Fax:971-231-2097
Practice Address - Street 1:3786 SW HALL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2050
Practice Address - Country:US
Practice Address - Phone:503-626-6587
Practice Address - Fax:971-231-2097
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR05080225100000X
OR5080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist