IndividualActive
Jackie Wolf, PT
NPI 1053502104 · Physical Therapist · Portland, OR
Provider details
- NPI number
- 1053502104
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- License
- 5452 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1111 Ne 99th Ave
Portland, OR 97220
Phone: (503) 216-5410
Fax: (503) 216-5420
Street-level locationGet directions
Mailing address
1111 Ne 99th
Portland, OR 97220-9428
Registry dates
- Enumerated
- 2007-08-05
- Last updated
- 2018-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.