IndividualActive
Brenda Jacob, PTA
NPI 1588063366 · Physical Therapy Assistant · Milwaukie, OR
Provider details
- NPI number
- 1588063366
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- License
- 08569 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
12045 Se Stanley Ave
Milwaukie, OR 97222-2938
Phone: (503) 659-2323
Approximate (ZIP-level) locationGet directions
Mailing address
6111 Sw Beaverton Hillsdale Hwy Apt 18
Portland, OR 97221-1161
Registry dates
- Enumerated
- 2014-08-18
- Last updated
- 2014-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.