PROKALEO PHYSICAL THERAPY, LLC (NPI# 1447813084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447813084 |
| Entity Type | Organization |
| Organization Name | PROKALEO PHYSICAL THERAPY, LLC |
| Practice Address |
12120 Sw Garden Pl Tigard OR 97223-8264 |
| Mailing Address |
153 Ne Jefferson St Hillsboro OR 97124-3183 |
| Practice Telephone | 9712568416 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |
| Authorized Official Name | KURT GILBERTSON (OWNER) |
| Authorized Official Telephone | 4802986351 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1467996983 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROKALEO PHYSICAL THERAPY, LLC | 5305 River Rd N Ste B, Keizer, OR 97303 |
| Street Address |
12120 SW GARDEN PL |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-8264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1639150428 | Steve Masuichi Nakano | Physical Therapist | 9250 Sw Hall Blvd, Tigard, OR 97223 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170411 | Mind Body Therapy | Physical Therapist | 11959 Sw Garden Pl, Portland, OR 97223-8249 | 2020-09-24 |
| 1811512320 | Wesley Stoecker | Physical Therapist | 512 Main St., Suite 300, Monmouth, OR 97361 | 2020-06-10 |
| 1629638952 | Alana Vernon | Physical Therapist | 625 N Arrowleaf Trl Bldg G, Sisters, OR 97759-2610 | 2019-06-18 |
| 1992369532 | Mansi S Sabne | Physical Therapist | 2460 Nw Stewart Pkwy Ste 200, Roseburg, OR 97471-1501 | 2019-04-29 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1578041976 | Sheridan Edward Pyeatt | Physical Therapist | 870 S Front St Ste 105, Central Point, OR 97502-2779 | 2018-07-30 |
| 1093204562 | Jessica Hund | Physical Therapist | 9385 Sw Greenburg Rd Ste 100, Portland, OR 97223-3200 | 2018-05-09 |
| 1659899151 | Mariel Hammond | Physical Therapist | 7522 N Lombard St, Portland, OR 97203-3235 | 2017-09-05 |
| 1437516515 | Caleb Joseph Wright | Physical Therapist | 8628 Se 17th Ave, Portland, OR 97202-0000 | 2016-01-20 |
| 1134584774 | Active Edge Physical Therapy, LLC | Physical Therapist | 19721 S Highway 213, Oregon City, OR 97045-4190 | 2015-12-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.