Provider Demographics
NPI:1568710291
Name:WALTERS, ASHLEIGH ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:ELIZABETH
Last Name:WALTERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:ASHLEIGH
Other - Middle Name:ELIZABETH
Other - Last Name:STROUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:20265 SW LELA LN
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97003-6554
Mailing Address - Country:US
Mailing Address - Phone:503-608-9939
Mailing Address - Fax:
Practice Address - Street 1:5208 NE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1074
Practice Address - Country:US
Practice Address - Phone:503-261-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6930225100000X
OR06930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist