MIND BODY THERAPY (NPI# 1578170411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578170411 |
| Entity Type | Organization |
| Organization Name | MIND BODY THERAPY |
| Practice Address |
11959 Sw Garden Pl Portland OR 97223-8249 |
| Practice Telephone | 5036200781 |
| Practice Fax Number | 5034279553 |
| Mailing Telephone | 5036200781 |
| Mailing Fax Number | 5034279553 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | RAJESH KHEMRAJ (OWNER) |
| Authorized Official Telephone | 5035604672 |
| 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 |
| Other Name | Type Code |
|---|---|
| Mind Body Therapy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MIND BODY THERAPY LLC | 11959 Sw Garden Pl, Tigard, OR 97223 |
| Massachusetts Corporations | MIND BODY THERAPY, INC. | 2557 Massachusetts Ave., Cambridge, MA 02140 |
| Street Address |
11959 SW GARDEN PL |
| City | PORTLAND |
| State | OR |
| Zip Code | 97223-8249 |
| 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 |
|---|---|---|---|---|
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 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 |
| 1881840692 | Jennifer Lynne Davis | Physical Therapist | 7718 Se 13th Ave, Portland, OR 97202-6348 | 2008-08-12 |
| 1093977316 | Julie A Jacobson | Physical Therapist | 10428 Ne Pacific St, Portland, OR 97220-4028 | 2008-06-27 |
| 1427225606 | Kofoed Enteprises PC | Physical Therapist | 1020 Sw Taylor Street Suite 665, Portland, OR 97205-2529 | 2008-05-15 |
| 1770619595 | Shawn Patrick Cooney | Physical Therapist | 3108 Ne 181st Ave, Portland, OR 97230-6926 | 2007-02-26 |
| 1811039035 | Kevin A Schmidt | Physical Therapist | 2622 Se 25th Ave, Suite B, Portland, OR 97202-1217 | 2007-02-13 |
| 1326133125 | Corrie Alena Black-rofinot | Physical Therapist | 11782 Sw Barnes Rd Ste 100, Portland, OR 97225-5931 | 2006-10-04 |
| Find all providers in PORTLAND | ||||
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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.