Provider Demographics
NPI:1588910319
Name:DARRINGTON PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:DARRINGTON PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:MARLIN
Authorized Official - Last Name:DARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, ATC
Authorized Official - Phone:503-623-9676
Mailing Address - Street 1:289 E ELLENDALE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-1580
Mailing Address - Country:US
Mailing Address - Phone:503-623-9676
Mailing Address - Fax:503-831-3854
Practice Address - Street 1:289 E ELLENDALE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1580
Practice Address - Country:US
Practice Address - Phone:503-623-9676
Practice Address - Fax:503-831-3854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty