Provider Demographics
NPI:1699731547
Name:MEIRA, ERIK (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:MEIRA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 SE 172ND AVE, SUITE 166
Mailing Address - Street 2:PMB 348
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-8738
Mailing Address - Country:US
Mailing Address - Phone:503-704-4088
Mailing Address - Fax:
Practice Address - Street 1:14111 SE TARNAHAN CT
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-6597
Practice Address - Country:US
Practice Address - Phone:503-704-4088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3962225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR182792Medicaid
OR182792Medicaid
R130767Medicare PIN