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

Individual provider Physical Therapist · NPI 1629402052

Timothy Michael Mansour, DPT is a Physical Therapist in Private Practice in Port Ludlow, Washington. Qualified in 2013, 13 years ago. Practices with Active Life Physical Therapy LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
13
Licensed in
OR, WA
In the registry since
2013
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

9483 Oak Bay Rd
Port Ludlow, WA 98365-9794
Phone: (360) 437-2444
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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 60401257 (WA)
Physical Therapist Taxonomy 225100000X · Licence 60311 (OR)

Record details

NPI number1629402052
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 21, 2013
Last updated in NPPESFebruary 13, 2014
Mailing address9483 Oak Bay Rd, Port Ludlow, WA 98365-9794

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Active Life Physical Therapy Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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