Provider Demographics
NPI:1548640113
Name:ASCENT PHYSICAL THERAPY LLP
Entity type:Organization
Organization Name:ASCENT PHYSICAL THERAPY LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:509-979-0204
Mailing Address - Street 1:16126 SE HAPPY VALLEY TOWN CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-4256
Mailing Address - Country:US
Mailing Address - Phone:503-427-0118
Mailing Address - Fax:503-427-0279
Practice Address - Street 1:16126 SE HAPPY VALLEY TOWN CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-4256
Practice Address - Country:US
Practice Address - Phone:503-427-0118
Practice Address - Fax:503-427-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500663726Medicaid
ORR172103Medicare PIN