Provider Demographics
NPI:1437438272
Name:MAYER, CHELESA ALBRECHT (DPT)
Entity Type:Individual
Prefix:MS
First Name:CHELESA
Middle Name:ALBRECHT
Last Name:MAYER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHELESA
Other - Middle Name:ALLYN
Other - Last Name:ALBRECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4807 NE AINSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-1820
Mailing Address - Country:US
Mailing Address - Phone:503-290-6554
Mailing Address - Fax:503-241-5484
Practice Address - Street 1:2330 NW FLANDERS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3442
Practice Address - Country:US
Practice Address - Phone:503-701-8766
Practice Address - Fax:503-241-5484
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist