Provider Demographics
NPI:1144709395
Name:MEND PHYSICAL THERAPY
Entity type:Organization
Organization Name:MEND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:SEFCOVIC
Authorized Official - Last Name:CHOPRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, COMT
Authorized Official - Phone:503-893-9857
Mailing Address - Street 1:3317 NE 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2306
Mailing Address - Country:US
Mailing Address - Phone:503-893-9857
Mailing Address - Fax:503-662-6024
Practice Address - Street 1:4230 NE FREMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1150
Practice Address - Country:US
Practice Address - Phone:503-893-9857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty