LEGACY MERIDIAN PARK PEDIATRIC REHAB; NPI #1801122593

Contact Information

LEGACY MERIDIAN PARK PEDIATRIC REHAB

19250 SW 65TH AVE STE 125
TUALATIN, OR 97062-7745

Phone: 503-413-4505
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Children	283XC2000X

Indicates primary specialty

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NPI Profile & details for LEGACY MERIDIAN PARK PEDIATRIC REHAB

NPI Number 1801122593

LBN Legal business name LEGACY MERIDIAN PARK PEDIATRIC REHAB

Authorized official SARAH JENSEN - (VP FINANCE)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/30/2009

Last updated 01/20/2026 - About 4 months ago

Identifiers

License #

930618915

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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LEGACY MERIDIAN PARK PEDIATRIC REHAB

Contact Information

Specialty

Children

NPI Profile & details for LEGACY MERIDIAN PARK PEDIATRIC REHAB

Reviews for LEGACY MERIDIAN PARK PEDIATRIC REHAB