Provider Demographics
NPI:1558767012
Name:MCELDOWNEY, COURTNEY (LMT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MCELDOWNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:RAE
Other - Last Name:GOSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:23440 SE STARK ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2961
Mailing Address - Country:US
Mailing Address - Phone:503-489-6245
Mailing Address - Fax:503-489-0552
Practice Address - Street 1:23440 SE STARK ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2961
Practice Address - Country:US
Practice Address - Phone:503-489-6245
Practice Address - Fax:503-489-0552
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17060225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist