Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Green Heron Physical Therapy LLC

Organization Physical Therapy Clinic/Center · NPI 1518558469

Green Heron Physical Therapy LLC is a Physical Therapy Clinic/Center in Portland, Oregon. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1706 NW 24th Ave Unit 96034
Portland, OR 97296-6613
Phone: (661) 717-9692
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X

Record details

NPI number1518558469
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mario Urdaneta-Moncada — Owner, Physical Therapist · (661) 717-9692
NPI enumeratedFebruary 2, 2021
Last updated in NPPESFebruary 2, 2021
Certification dateJanuary 6, 2021
Mailing addressPo Box 96034, Portland, OR 97296-6000

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