Provider Demographics
NPI:1558526236
Name:ANSLINGER, MICHELLE MARIE (DPT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MARIE
Last Name:ANSLINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 LONE PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-9403
Mailing Address - Country:US
Mailing Address - Phone:541-296-7202
Mailing Address - Fax:541-298-8008
Practice Address - Street 1:115 W 4TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-1803
Practice Address - Country:US
Practice Address - Phone:541-298-8985
Practice Address - Fax:541-298-8008
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist