| Kerry Michelle Boduch, PT | |
|
2500 Nw 229th Ave Bldg E, Ste 200, Hillsboro, OR 97124-7516 | |
| (503) 395-3000 | |
| (503) 336-0464 |
| Full Name | Kerry Michelle Boduch |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 2500 Nw 229th Ave Bldg E, Hillsboro, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629484217 | NPI | - | NPPES |
| 1244700 | Other | TX | LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 61167 (Oregon) | Primary |
| 225100000X | Physical Therapist | 1244700 (Texas) | Secondary |
| Provider Name | Nevada Luna Care Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1457087009 PECOS PAC ID: 6901280510 Enrollment ID: O20220831001956 |
| Mailing Address | Practice Location Address |
|---|---|
| Kerry Michelle Boduch, PT 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: (630) 296-2223 | Kerry Michelle Boduch, PT 2500 Nw 229th Ave Bldg E, Ste 200, Hillsboro, OR 97124-7516 Ph: (503) 395-3000 |
Janet R Oconnor, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 862 Se Oak St, Suite 2a, Hillsboro, OR 97123 Phone: 503-844-6565 Fax: 503-844-4225 | |
Nancy Ann Cicirello, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 222 Se 8th Ave, Hillsboro, OR 97123 Phone: 503-352-7253 Fax: 503-352-7340 | |
Christopher John Renner, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 7305 Se Circuit Dr Ste 140, Hillsboro, OR 97123 Phone: 971-501-4905 | |
Mrs. Tawnie Dean Cowan, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 936 Se Oak St, Hillsboro, OR 97123 Phone: 503-546-6392 Fax: 503-546-9150 | |
Marie Pielage, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 335 Se 8th Ave, Hillsboro, OR 97123 Phone: 503-640-6006 | |
Miguel Paniagua Rodriguez, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1200 Ne 48th Ave Ste 700, Hillsboro, OR 97124 Phone: 503-640-6064 | |
Tiffany Kugiya, Physical Therapist Medicare: Medicare Enrolled Practice Location: 5920 Ne Ray Cir Ste 160, Hillsboro, OR 97124 Phone: 503-844-9294 |