Provider Demographics
NPI:1477690907
Name:MCDONNELL, ANNE ELISABETH (MSPT, BSPT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:ELISABETH
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:MSPT, BSPT
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:ELISABETH
Other - Last Name:AMSBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1911
Mailing Address - Street 2:
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759-1911
Mailing Address - Country:US
Mailing Address - Phone:541-299-0294
Mailing Address - Fax:541-549-1272
Practice Address - Street 1:325 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759-5047
Practice Address - Country:US
Practice Address - Phone:541-549-3534
Practice Address - Fax:916-483-4890
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist