Provider Demographics
NPI:1750494431
Name:QUIGLEY, ELIZABETH PEREZ (MSPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PEREZ
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:10114 SE DEREK LOOP
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97266-7275
Mailing Address - Country:US
Mailing Address - Phone:503-788-2549
Mailing Address - Fax:
Practice Address - Street 1:2701 NW VAUGHN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5311
Practice Address - Country:US
Practice Address - Phone:503-721-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4717225100000X
WAPT00009392225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist