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

Individual provider Physical Therapy Assistant · NPI 1336405075

Jackie Louise Moffenbier, PTA is a Physical Therapy Assistant in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2012.

Licensed in
OR
In the registry since
2012
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

6010 SW Shattuck Rd
Portland, OR 97221
Phone: (503) 246-8811
Fax: (503) 246-9957
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 07104 (OR)

Record details

NPI number1336405075
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedApril 6, 2012
Last updated in NPPESApril 6, 2012

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