Provider Demographics
NPI:1619203486
Name:ELLEN FINEMAN PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:ELLEN FINEMAN PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:503-885-1480
Mailing Address - Street 1:19767 SW 72ND AVE
Mailing Address - Street 2:SUITE 102 B
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8354
Mailing Address - Country:US
Mailing Address - Phone:503-885-1480
Mailing Address - Fax:503-885-2129
Practice Address - Street 1:19767 SW 72ND AVE
Practice Address - Street 2:SUITE 102 B
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8354
Practice Address - Country:US
Practice Address - Phone:503-885-1480
Practice Address - Fax:503-885-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1009261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy