| Portland Sports Medicine & Spine Physical Therapy Inc. | |
|
1610 Se Glenwood St, Portland, OR 97202-5615 | |
| (503) 230-1744 | |
| (503) 230-1745 |
| Full Name | Portland Sports Medicine & Spine Physical Therapy Inc. |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 1610 Se Glenwood St, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215127873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 4503 (Oregon) | Primary |
| Provider Name | Aimee C Guarriello |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689703944 PECOS PAC ID: 8325949555 Enrollment ID: I20040120000271 |
| Provider Name | Michael P Quesnell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497775480 PECOS PAC ID: 8729050828 Enrollment ID: I20040810000251 |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Sports Medicine & Spine Physical Therapy Inc. 1610 Se Glenwood St, Portland, OR 97202-5615 Ph: (503) 230-1744 | Portland Sports Medicine & Spine Physical Therapy Inc. 1610 Se Glenwood St, Portland, OR 97202-5615 Ph: (503) 230-1744 |
Jonathan Rex Gustavson, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3426 Ne 62nd Ave, Portland, OR 97213 Phone: 503-312-3443 | |
Ms. Ruth A Hurst, P.T., G.C.F.P. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7721 Sw 34th Ave, Portland, OR 97219 Phone: 503-452-7767 | |
Ms. Molly Anne Bredenberg, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5050 Ne Hoyt St, Portland, OR 97213 Phone: 503-215-0424 | |
David Genco Jr., DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 319 Ne Russet St, Portland, OR 97211 Phone: 503-289-5571 | |
Jenna Valentine, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 9204 Se Mitchell St, Portland, OR 97266 Phone: 503-777-6746 | |
Ariel Witkin, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1515 Nw 18th Ave Ste 400, Portland, OR 97209 Phone: 503-228-1306 Fax: 503-228-1307 | |
Olivia Aho, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2808 E Burnside St, Portland, OR 97214 Phone: 503-447-4802 |