Farah Grace Custodio
Farah Grace Custodio is a Physical Therapist in Private Practice in Forest Grove, Oregon. Qualified in 2005, 21 years ago. Practices with Custom Care Physical Therapy, LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Oregon.
- Years since qualifying
- 21
- Licensed in
- OR
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
3838 Pacific AveForest Grove, OR 97116-2224
Phone: (503) 357-1706
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Orthopedic Physical Therapist (primary) | Taxonomy 2251X0800X · Licence 64412 (OR) |
|---|---|
| Physical Therapy Clinic/Center | Taxonomy 261QP2000X · Licence 64412 (OR) |
Record details
| NPI number | 1740924620 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | April 26, 2022 |
| Last updated in NPPES | October 22, 2024 |
| Certification date | October 22, 2024 |
| Mailing address | 1000 Nw 123rd Ave Apt 1, Portland, OR 97229-5673 |
Medicare enrollment
| Medicare specialty | PHYSICAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2005 (21 years in practice) |
| Group practice | Custom Care Physical Therapy, Llc — 5 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Forest Grove
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Custom Care Physical Therapy, LLC
3838 Pacific Ave, Forest Grove, OR 97116-2224 · (503) 357-1706