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

Dr. Timothy Max Wallenburg, PT, DPT

Individual provider Physical Therapist · NPI 1497358451

Dr. Timothy Max Wallenburg, PT, DPT is a Physical Therapist in Private Practice in Sandy, Oregon. Qualified in 2019, 7 years ago. Practices with New Proactive LLC, a 53-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
7
Licensed in
OR
In the registry since
2020
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

17420 Meinig Ave
Sandy, OR 97055-8068
Phone: (503) 427-0118
Fax: (503) 427-0279
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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 65063 (OR)

Record details

NPI number1497358451
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedNovember 20, 2020
Last updated in NPPESOctober 6, 2025
Certification dateOctober 6, 2025
Mailing address2001 Solar Dr Ste 150, Oxnard, CA 93036-0680

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice New Proactive Llc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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