OrganizationActive
Stout Performance and Physical Therapy LLC
NPI 1790593739 · Sports Physical Therapist · Portland, OR
Provider details
- NPI number
- 1790593739
- Entity type
- Organization
- Primary specialty
- Sports Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Jake Stout, Owner/Provider(503) 949-1727
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
710 Ne Holladay St # 150
Portland, OR 97232-2168
Phone: (503) 542-2744
Approximate (ZIP-level) locationGet directions
Mailing address
710 Ne Holladay St # 150
Portland, OR 97232-2168
Registry dates
- Enumerated
- 2024-12-23
- Last updated
- 2024-12-23
- Certified
- 2024-12-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.