Provider Demographics
NPI:1518433408
Name:ORTON, ELYSE AUBREE
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:AUBREE
Last Name:ORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 EVERETT WAY UNIT C
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-2372
Mailing Address - Country:US
Mailing Address - Phone:720-220-7237
Mailing Address - Fax:
Practice Address - Street 1:4500 E CHERRY CREEK SOUTH DR STE 710
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1534
Practice Address - Country:US
Practice Address - Phone:303-432-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA-0001058224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant