Provider Demographics
NPI:1467668418
Name:HUFFINGTON-CARROLL, ANNE DAVIS (MPT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:DAVIS
Last Name:HUFFINGTON-CARROLL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7062 NE EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5632
Mailing Address - Country:US
Mailing Address - Phone:503-252-3975
Mailing Address - Fax:503-238-4553
Practice Address - Street 1:5420 NE GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3063
Practice Address - Country:US
Practice Address - Phone:503-215-4033
Practice Address - Fax:503-238-4553
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR40212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic