| Gabriel Joseph Camilli, | |
|
3838 Pacific Ave, Forest Grove, OR 97116-2224 | |
| (503) 357-1706 | |
| (503) 270-5023 |
| Full Name | Gabriel Joseph Camilli |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 3838 Pacific Ave, Forest Grove, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669180840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (Oregon) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Custom Care Physical Therapy, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1508005026 PECOS PAC ID: 0941365514 Enrollment ID: O20090213000402 |
| Mailing Address | Practice Location Address |
|---|---|
| Gabriel Joseph Camilli, 1526 Hawthorne St, Forest Grove, OR 97116-2536 Ph: (971) 205-4441 | Gabriel Joseph Camilli, 3838 Pacific Ave, Forest Grove, OR 97116-2224 Ph: (503) 357-1706 |
Alexandra Kristine Thomas, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3300 19th Ave, Forest Grove, OR 97116 Phone: 503-357-7119 | |
Cheryl Lee Fletcher, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1006 Watercrest Rd, Forest Grove, OR 97116 Phone: 971-732-9436 | |
Mrs. Diana Kay Lubarsky, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2333 Pacific Avenue, Tuality Healthcare Forest Grove Shopping Center, Forest Grove, OR 97116 Phone: 503-359-6145 Fax: 503-359-6919 | |
Mr. James D Surface, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1909 Mountain View Ln #300, Forest Grove, OR 97116 Phone: 503-359-3979 Fax: 503-648-2441 | |
Julie Bernice Lum, PT, DPT, OCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2333 Pacific Ave, Forest Grove, OR 97116 Phone: 503-359-6145 | |
Mr. Aaron Michael Frye, M.S.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4150 Pacific Ave, Ste 100, Forest Grove, OR 97116 Phone: 503-357-1706 Fax: 503-270-5023 | |
Alison Modafferi, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2005 Elm St Ste 200, Forest Grove, OR 97116 Phone: 503-357-9810 Fax: 503-357-9819 |