Provider Demographics
NPI:1639253255
Name:FINEMAN, ELLEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:
Last Name:FINEMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19767 SW 72ND AVE
Mailing Address - Street 2:SUITE 102B
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 102B
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
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist