Provider Demographics
NPI:1912565623
Name:CORREIA-JEFFERS, MICHELLE K (DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:K
Last Name:CORREIA-JEFFERS
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 1:16055 SW WALKER RD STE 188
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-4942
Mailing Address - Country:US
Mailing Address - Phone:530-638-5848
Mailing Address - Fax:
Practice Address - Street 1:17323 SW JAY ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-7626
Practice Address - Country:US
Practice Address - Phone:530-638-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist