| Kristoffer De Leon, | |
|
210 W Ellendale Ave Ste 100, Dallas, OR 97338-1790 | |
| (503) 623-2433 | |
| Not Available |
| Full Name | Kristoffer De Leon |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 210 W Ellendale Ave Ste 100, Dallas, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821828849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 65442 (Oregon) | Primary |
| Provider Name | Northwest Rehabilitation Associates Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1972505790 PECOS PAC ID: 5991753592 Enrollment ID: O20050111000263 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristoffer De Leon, 210 W Ellendale Ave Ste 100, Dallas, OR 97338-1790 Ph: (503) 623-2433 | Kristoffer De Leon, 210 W Ellendale Ave Ste 100, Dallas, OR 97338-1790 Ph: (503) 623-2433 |
Timothy Ryan Jamar, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 377 Nw Jasper St, Dallas, OR 97338 Phone: 503-623-5581 | |
Rolf Jett Vognild, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 17550 Gardner Rd, Dallas, OR 97338 Phone: 503-623-4084 | |
Melinda Walker, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 322 Main St # 326, Dallas, OR 97338 Phone: 503-837-1316 | |
Troy J Hattan, PHYSICAL THERAPIST Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 525 Se Washington St, Dallas, OR 97338 Phone: 503-623-7305 Fax: 503-623-7325 | |
Braedon Clay Miller, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 641 Se Miller Ave, Dallas, OR 97338 Phone: 503-623-7305 | |
Mr. Alan M Noble, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 210 W Ellendale Ave Ste 100, Dallas, OR 97338 Phone: 503-623-2433 Fax: 503-623-2196 | |
Dr. Lea Camille Domingo Keenantasker, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 377 Nw Jasper St, Dallas, OR 97338 Phone: 503-623-5581 |