OrganizationActive
Village Physical Therapy, LLC
NPI 1639638489 · Physical Medicine & Rehabilitation Physician · Portland, OR
Provider details
- NPI number
- 1639638489
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tam Cotton, Office Administrator(503) 389-5754
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 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
8430 Sw 22nd Ave
Portland, OR 97219-2856
Phone: (503) 389-5754
Fax: (503) 966-1459
Street-level locationGet directions
Mailing address
3521 Sw Comus St
Portland, OR 97219-7561
Registry dates
- Enumerated
- 2019-03-19
- Last updated
- 2025-09-15
- Certified
- 2025-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.