IndividualActive
Farah Custodio
NPI 1740924620 · Orthopedic Physical Therapist · Forest Grove, OR
Provider details
- NPI number
- 1740924620
- Entity type
- Individual
- Primary specialty
- Orthopedic Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 64412 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Ambulatory Health Care Facilities
Practice location
3838 Pacific Ave
Forest Grove, OR 97116-2224
Phone: (503) 357-1706
Approximate (ZIP-level) locationGet directions
Mailing address
1000 Nw 123rd Ave Apt 1
Portland, OR 97229-5673
Registry dates
- Enumerated
- 2022-04-26
- Last updated
- 2024-10-22
- Certified
- 2024-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.