Jeb Riley Wild, DPT

Physical Therapist · Gresham, OR

Individual Active NPI

NPI number 1497526222

Practice location

24076 SE Stark St Ste 200
Gresham, OR 97030-3376
Phone
(503) 491-1666

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NPI record

NPI
1497526222
Entity type
Individual (Type 1)
Enumeration date
January 10, 2024
Last updated
January 10, 2024
Certified
January 10, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapist Primary 225100000X 65159 OR

Mailing address

140 SW Columbia St Apt 1502
Portland, OR 97201-5887
Phone
(772) 971-1144

About Dr. Wild

Jeb Riley Wild, DPT is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapist (code 225100000X). The practice location is 24076 SE Stark St Ste 200, Gresham, OR 97030-3376. The NPI number 1497526222 was assigned on January 10, 2024 and the record was last updated on January 10, 2024.

Dr. Wild lists a license in the registry: #65159 (OR) for Physical Therapist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jeb Riley Wild, DPT?

The NPI number is 1497526222.

What is the phone number of Dr. Wild?

The phone number listed for the practice location is (503) 491-1666.

Where is Dr. Wild located?

24076 SE Stark St Ste 200, Gresham, OR 97030-3376.

What is the taxonomy code for Dr. Wild?

The primary taxonomy code is 225100000X – Physical Therapist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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