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

Mrs. Kathy Smith Wijaya, PT

Individual provider Physical Therapist · NPI 1619226990

Mrs. Kathy Smith Wijaya, PT is a Physical Therapist in Private Practice in Clackamas, Oregon. Qualified in 1997, 29 years ago. Licensed in Oregon.

Years since qualifying
29
Licensed in
OR
In the registry since
2012
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone: (503) 571-2091
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 4057 (OR)

Record details

NPI number1619226990
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 2, 2012
Last updated in NPPESOctober 1, 2025
Certification dateOctober 1, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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