| Tracing Beta Llc | |
|
2801 15th Pl, Forest Grove, OR 97116-3107 | |
| (352) 219-5930 | |
| Not Available |
| Full Name | Tracing Beta Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 2801 15th Pl, Forest Grove, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992466817 | NPI | - | NPPES |
| 1861896185 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Jason T Bouwkamp |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861896185 PECOS PAC ID: 3173847100 Enrollment ID: I20150123000199 |
| Mailing Address | Practice Location Address |
|---|---|
| Tracing Beta Llc 2801 15th Pl, Forest Grove, OR 97116-3107 Ph: (352) 219-5930 | Tracing Beta Llc 2801 15th Pl, Forest Grove, OR 97116-3107 Ph: (352) 219-5930 |
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 |