Provider Demographics
NPI:1700554458
Name:ANDRADA, GEORGE (DPT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:ANDRADA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 SE SUNNYBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6804
Mailing Address - Country:US
Mailing Address - Phone:503-607-2226
Mailing Address - Fax:
Practice Address - Street 1:8810 SE SUNNYBROOK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6805
Practice Address - Country:US
Practice Address - Phone:503-607-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty