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

Blake Golden

Individual provider Physical Therapist · NPI 1790537306

Blake Golden is a Physical Therapist in Private Practice in Scappoose, Oregon. Qualified in 2023, 3 years ago. Practices with Ideal Physical Therapy of Texas LLC, a 360-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Nevada and Oregon.

Years since qualifying
3
Licensed in
NV, OR
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

51385 SW Old Portland Rd Ste E
Scappoose, OR 97056-4062
Phone: (503) 543-7768
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3155 W Craig Rd Ste 120-140, North Las Vegas, NV 89032-0782 — (702) 639-2333

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 65565 (OR)
Physical Therapist Taxonomy 225100000X (NV)

Record details

NPI number1790537306
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 5, 2024
Last updated in NPPESDecember 18, 2024
Certification dateDecember 18, 2024
Mailing address2001 Butterfield Rd Ste 1600, Downers Grove, IL 60515-1211

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Ideal Physical Therapy Of Texas Llc — 360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Scappoose