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

Revive Physical Therapy LLC

Organization Physical Medicine & Rehabilitation Physician · NPI 1457819534

Revive Physical Therapy LLC is a Physical Medicine & Rehabilitation Physician in Portland, Oregon. Registered with an NPI since 2019.

In the registry since
2019
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

18019 SW Lowr Boones Ferry RD
Portland, OR 97224
Phone: (503) 691-2723
Fax: (503) 692-5406
Show map & directions

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

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X

Record details

NPI number1457819534
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenton Brook — President · (503) 691-2723
NPI enumeratedMarch 7, 2019
Last updated in NPPESMarch 7, 2019
Mailing address18019 Sw Lower Boones Ferry Rd, Portland, OR 97224

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