Provider Demographics
NPI:1124323423
Name:CALLAHAN, ALLISON GARRITY (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:GARRITY
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:THEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1500 SW 1ST AVE.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201
Mailing Address - Country:US
Mailing Address - Phone:503-222-1955
Mailing Address - Fax:503-222-1485
Practice Address - Street 1:1500 SW 1ST AVE.
Practice Address - Street 2:SUITE 150
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201
Practice Address - Country:US
Practice Address - Phone:503-222-1955
Practice Address - Fax:503-222-1485
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5432225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist