Provider Demographics
NPI:1962609651
Name:BOWMAN, PATRICIA K (PT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:K
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:PATTY
Other - Middle Name:K
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:9130 SW 190TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6733
Mailing Address - Country:US
Mailing Address - Phone:503-591-7465
Mailing Address - Fax:
Practice Address - Street 1:18650 NW CORNELL RD
Practice Address - Street 2:SUITE 314
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9207
Practice Address - Country:US
Practice Address - Phone:503-216-9760
Practice Address - Fax:503-216-9765
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist