Provider Demographics
NPI:1346402450
Name:PERRY, ANNA E (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:E
Last Name:PERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:E
Other - Last Name:TENSMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3270 LIBERTY RD S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302
Mailing Address - Country:US
Mailing Address - Phone:503-371-0779
Mailing Address - Fax:503-371-0886
Practice Address - Street 1:3270 LIBERTY RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302
Practice Address - Country:US
Practice Address - Phone:503-371-0779
Practice Address - Fax:503-371-0886
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT5665225100000X
OR5665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR166517Medicare UPIN