ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) – Physical Therapist, NPI 1346511649

ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) is a healthcare provider. based in Portland, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 62722 (OR). The NPI Number for ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) is 1346511649

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT)
NPI
1346511649
Phone
(503) 960-3047
Address
2257 SE 43RD AVE
Enumeration Date
18 January 2012
Last Update Date
11 June 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
50322101612110
Graduation Year
2018 (8 years ago)
PAC ID
6709279565
Group Practice PAC ID
8224942867
Professional Enrollment ID
I20220131002519
Address ID
OR972051902PO800XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

Provider Addresses for ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT)

  • 2257 SE 43RD AVE

    PORTLAND, OR 972153711

    Phone: (503) 960-3047

    Type: Mailing

  • 4560 SE INTERNATIONAL WAY STE 100

    MILWAUKIE, OR 97222

    Phone: (971) 206-5202

    Type: Location

  • 9830 NE Cascades Pkwy

    Ste 200

    Portland, OR 972206832

    Phone: (503) 575-8325

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-01-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220131002519IPhysical Therapist In Private PracticeORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97215)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224942867View full group profile
NameSpecialtyState
Family PracticeOR
O B S T E T R I C S/ G Y N E C O L O G YOR
-OR
Sports MedicineOR
-OR
Physician AssistantOR
Physician AssistantOR
Nurse PractitionerOR
O P T O M E T R YOR
O B S T E T R I C S/ G Y N E C O L O G YOR

Reviews

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Frequently asked questions

How is ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) identified in CMS data?
CMS-hosted NPPES data lists ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) with NPI 1346511649.
Does the file indicate ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) is practicing under active NPI?
Directory data currently reports ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) as active.
What is ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) best known for clinically?
Directory data describes ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) based?
ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) is tied to Portland, Oregon in the data we show; additional addresses may exist on the full record.
Why does ANDREA KATHRYN KUEBBING MULLIGAN (PT, DPT) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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