OrganizationActive
Childrens Intensive Therapy Northwest
NPI 1477886232 · Pediatric Physical Therapist · Portland, OR
Provider details
- NPI number
- 1477886232
- Entity type
- Organization
- Primary specialty
- Pediatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Darren Brault, Owner(971) 570-5043
- License
- 5680 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
7203 Se Raymond St
Portland, OR 97206-4323
Phone: (503) 895-1320
Fax: (503) 296-2319
Approximate (ZIP-level) locationGet directions
Mailing address
12948 Se Winston Rd
Damascus, OR 97089-7606
Registry dates
- Enumerated
- 2009-09-11
- Last updated
- 2013-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.