National Provider Identifier Database

LEGACY MERIDIAN PARK PEDIATRIC REHAB
Children


Contact Information

LEGACY MERIDIAN PARK PEDIATRIC REHAB
19250 SW 65TH AVE STE 125
TUALATIN, OR97062-7745
Phone: 503-413-4505
Fax:
Website:
Specialty Taxonomy Code
* Children 283XC2000X

* Indicates primary specialty

NPI Profile & details for LEGACY MERIDIAN PARK PEDIATRIC REHAB

NPI Number 1801122593
Legal business name
LBN
LEGACY MERIDIAN PARK PEDIATRIC REHAB
Authorized official SARAH JENSEN - (VP FINANCE)
Entity Organization
Organization subpart No
Enumeration date 10/30/2009
Last updated 01/20/2026 - About 4 months ago
Sole proprietor1 Not specified
Identifiers
  • OR License #: 930618915

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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