Provider Demographics
NPI:1770199283
Name:SLAPE, REBECCA CHERI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:CHERI
Last Name:SLAPE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S BANCROFT ST STE B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-8523
Mailing Address - Country:US
Mailing Address - Phone:503-821-0621
Mailing Address - Fax:971-254-8979
Practice Address - Street 1:110 S BANCROFT ST STE B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-8523
Practice Address - Country:US
Practice Address - Phone:503-821-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-20
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist