| Organization Name: | PROACTIVE PHYSICAL THERAPY TUALATIN |
| NPI Number: | 1003295775 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE MCCALL (BILLING DIRECTOR / CREDENTIALING) |
| Mailing Address: | 19255 Sw 65th Ave Suite 250 Tualatin |
| State: | OR US |
| Postal Code: | 970627451 |
| Phone Number: | 5035450526 |
| Fax Number: | 5038554568 |
| NPI Enumeration Date: | 05/27/2015 |
| NPI Last Update Date: | 02/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |