Provider Demographics
NPI:1598963654
Name:GORE, BETH ELIESE (MS, PT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ELIESE
Last Name:GORE
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 NE ELAM YOUNG PKWY
Mailing Address - Street 2:ORENCO REHAB SERVICES
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6452
Mailing Address - Country:US
Mailing Address - Phone:503-216-1690
Mailing Address - Fax:503-216-1695
Practice Address - Street 1:5555 NE ELAM YOUNG PKWY
Practice Address - Street 2:ORENCO REHAB SERVICES
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6452
Practice Address - Country:US
Practice Address - Phone:503-216-1690
Practice Address - Fax:503-216-1695
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist