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

C Thomas Provenzano, MPT

Individual provider Physical Therapist · NPI 1548241995

C Thomas Provenzano, MPT is a Physical Therapist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2005.

Licensed in
OR
In the registry since
2005
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

9260 SE Stark St Ste B
Portland, OR 97216-1675
Phone: (503) 255-1500
Fax: (503) 255-1560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2227 (OR)

Record details

NPI number1548241995
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT
Sole proprietorNo
NPI enumeratedNovember 10, 2005
Last updated in NPPESJuly 13, 2026

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