Basic Information
| Provider Information | |||||||||
| NPI: | 1558311035 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | RAMSEY | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | PT, DPT, OCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5052 NW 177TH AVE | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972297310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178772575 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4829 NE MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972113491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032838133 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 04/13/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 15079 | MA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251X0800X | 6125 | OR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
ID Information
| ID | Type | State | Issuer | Description | 500616455 | 05 | OR | MEDICAID |