Provider Demographics
NPI:1235485053
Name:GEORGE, NICK ADAM (PT)
Entity type:Individual
Prefix:
First Name:NICK
Middle Name:ADAM
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7305 SE CIRCUIT DR STE 140
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-1961
Mailing Address - Country:US
Mailing Address - Phone:971-501-4905
Mailing Address - Fax:503-215-0583
Practice Address - Street 1:7305 SE CIRCUIT DR STE 140
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-1961
Practice Address - Country:US
Practice Address - Phone:971-501-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR40662251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR4066OtherOREGON LICENSE NUMBER