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

Mr. Michael William Ellis, PTA

Individual provider Physical Therapy Assistant · NPI 1235788936

Mr. Michael William Ellis, PTA is a Physical Therapy Assistant in Portland, Oregon. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2019
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

12441 SE Stark St
Portland, OR 97233-1053
Phone: (503) 255-7040
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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 09797 (PA)

Record details

NPI number1235788936
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedSeptember 5, 2019
Last updated in NPPESSeptember 5, 2019

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