Provider Demographics
NPI:1568773380
Name:MITCHELL, ELSA BESS (DPT)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:BESS
Last Name:MITCHELL
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 1:1836 NE 7TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3998
Mailing Address - Country:US
Mailing Address - Phone:503-206-6218
Mailing Address - Fax:
Practice Address - Street 1:1836 NE 7TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3998
Practice Address - Country:US
Practice Address - Phone:503-206-6218
Practice Address - Fax:888-972-1720
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist