Provider Demographics
NPI:1689862336
Name:COMPTON-GRIFFITH, KELSI N (DPT)
Entity Type:Individual
Prefix:MISS
First Name:KELSI
Middle Name:N
Last Name:COMPTON-GRIFFITH
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 1:1380 NW LANCASHIRE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-3314
Mailing Address - Country:US
Mailing Address - Phone:503-866-3610
Mailing Address - Fax:
Practice Address - Street 1:1380 NW LANCASHIRE CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-3314
Practice Address - Country:US
Practice Address - Phone:503-866-3610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist