OrganizationActive
Holographic Body LLC
NPI 1710752191 · Physical Therapy Clinic/Center · Portland, OR
Provider details
- NPI number
- 1710752191
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Adam Persinger, Owner(541) 954-7091
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
3014 Ne Killingsworth
Portland, OR 97211
Phone: (541) 954-7091
Street-level locationGet directions
Mailing address
3834 Ne Simpson St
Portland, OR 97211-7961
Registry dates
- Enumerated
- 2023-11-16
- Last updated
- 2023-11-16
- Certified
- 2023-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.