| Doctor Name: | MR. DONALD REX MONTGOMERY |
| NPI Number: | 1083058341 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT,DPT |
| License Number: | 01767 |
| Business Practice Address: | 25030 Sw Parkway Ave Suite 123 Wilsonville, OR - 970709816 |
| Business Phone Number: | 5035821073 |
| Business Fax Number: | |
| Mailing Address: | 4111 Ne Alameda St, PORTLAND |
| State: | OR |
| Postal Code: | 972122910 |
| Phone Number: | 5032845811 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2013 |
| NPI Last Update Date: | 04/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 01767 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |