- Practice location
- 5465 SW Western Ave Ste H, Beaverton, OR 97005-4179
- Phone
- 503-610-9281
- Fax
- —
- Last updated
- March 6, 2025
Jack Anderson is a Physical Therapist based in Beaverton, OR. Jack Anderson practices in Beaverton, OR and has the professional credentials of DPT. The NPI Number for Jack Anderson is 1205400702 and holds a License No. 64087 (OR). The current practice location address for Jack Anderson is 5465 SW Western Ave Ste H, Beaverton, OR 97005-4179 and can be reached out via phone at 503-610-9281.
Provider Profile Details
- NPI Number
- 1205400702
- Provider Name
- Jack Anderson
- Credential
- DPT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 5465 SW Western Ave Ste H, Beaverton, OR 97005-4179
- Phone Number
- 503-610-9281
- Primary Taxonomy
- Physical Therapist · 225100000X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 18, 2021
- Last Update Date
- March 6, 2025
- Certification Date
- March 6, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 5465 SW Western Ave Ste H
Beaverton, OR 97005-4179 - City
- Beaverton
- State
- Oregon
- Zip
- 97005-4179
- Phone Number
- 503-610-9281
Provider Business Mailing Address Details
- Address
- 5465 SW Western Ave Ste H
Beaverton, OR 97005-4179 - City
- Beaverton
- State
- OR
- Zip
- 97005-4179
- Phone Number
- 503-610-9281
License Information
- License Number (1)
- 64087
- License State (1)
- OR
- Taxonomy (1)
- Physical Therapist · 225100000X · Primary
- Taxonomy (2)
- Physical Therapist · 225100000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jack Anderson, DPT?
The NPI number of Jack Anderson, DPT is 1205400702. It was assigned on May 18, 2021 and is currently active in the NPPES registry.
What is the specialty of Jack Anderson, DPT?
Jack Anderson, DPT is registered under the primary taxonomy Physical Therapist (code 225100000X), licensed in OR under license number 64087.
Where does Jack Anderson, DPT practice?
The practice location is 5465 SW Western Ave Ste H, Beaverton, OR 97005-4179. The office can be reached at 503-610-9281 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1205400702 directly on the NPPES registry website.