| Rylee Pittullo, | |
|
25500 Se Stark St Ste 103, Gresham, OR 97030-8327 | |
| (503) 328-0222 | |
| (503) 328-0223 |
| Full Name | Rylee Pittullo |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist In Private Practice |
| Location | 25500 Se Stark St Ste 103, Gresham, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043146855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 66147 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| New Proactive Llc | 7315218708 | 53 |
| 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 |
|---|---|
| Rylee Pittullo, 1650 Lyndon Farm Ct Ste 300, Louisville, KY 40223-5005 Ph: (726) 202-3039 | Rylee Pittullo, 25500 Se Stark St Ste 103, Gresham, OR 97030-8327 Ph: (503) 328-0222 |
Namita Avarsekar, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 304 Ne Hood Ave, Gresham, OR 97030 Phone: 503-666-1333 Fax: 503-666-2444 |
Paul Song Eo, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 24076 Se Stark St Ste 200, Gresham, OR 97030 Phone: 503-491-1666 |
Mr. Clem George Eischen Jr., PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 24076 Se Stark St, Gresham, OR 97030 Phone: 503-491-1666 |
Bradley Roy Eisenhut, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 283 Ne 223rd Ave, Gresham, OR 97030 Phone: 503-912-1192 |
Lindsey Soule, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 304 Ne Hood Ave Ste 100, Gresham, OR 97030 Phone: 503-666-1333 |
Kaeli Frank, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7927 Se Orient Dr, Gresham, OR 97080 Phone: 503-663-0481 |
Stacia Akers, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 24800 Se Stark St, Gresham, OR 97030 Phone: 503-413-3879 Fax: 503-413-4379 |