Provider Demographics
NPI:1669149803
Name:STROBBE, PAIGE (PTA)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:
Last Name:STROBBE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:TYNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:25117 SW PARKWAY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10842 OLD MILL RD STE 1
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2653
Practice Address - Country:US
Practice Address - Phone:402-934-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1317225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant