| Mr Tyler Marc Bohnet, MPT | |
|
308 N Ivy St, Canby, OR 97013-3704 | |
| (503) 263-6786 | |
| (503) 263-6451 |
| Full Name | Mr Tyler Marc Bohnet |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 27 Years |
| Location | 308 N Ivy St, Canby, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184603821 | NPI | - | NPPES |
| 30062200 | Other | REGENCE HMO | |
| 825473002 | Other | REGENCE PPO | |
| 226568 | Medicaid | OR | |
| K981106 | Other | PACIFIC SOURCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | OR 4082 (Oregon) | Primary |
| 225100000X | Physical Therapist | PT 00008327 (Washington) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| New Proactive Llc | 7315218708 | 42 |
| Provider Name | New Proactive Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1396273199 PECOS PAC ID: 7315218708 Enrollment ID: O20170901001937 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Tyler Marc Bohnet, MPT Po Box 52194, Dept Code 960, Phoenix, AZ 85072-2194 Ph: (503) 489-1781 | Mr Tyler Marc Bohnet, MPT 308 N Ivy St, Canby, OR 97013-3704 Ph: (503) 263-6786 |
Ms. Dana F Van Der Kieft, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 308 N Ivy St, Canby, OR 97013 Phone: 503-263-6786 Fax: 503-263-6451 | |
Ms. Jessica Ellen Karlson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1577 South Ivy St., Canby, OR 97013 Phone: 503-266-5541 Fax: 503-266-5544 | |
Christian Ricardo Miranda, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 S Hazel Dell Way Ste 210, Canby, OR 97013 Phone: 503-263-9550 | |
Kristin Jane Zosel, MS PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 308 N Ivy St, Canby, OR 97013 Phone: 503-263-6786 Fax: 503-263-6451 | |
Jennifer Bissig, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 365 S Redwood St, Canby, OR 97013 Phone: 503-651-2020 | |
Kendra Shaun Martin, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1535 S Ivy St, Canby, OR 97013 Phone: 503-266-5541 |