Provider Demographics
NPI:1265909352
Name:NEUHOLD, ASHLEY ANJELICA (ATC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANJELICA
Last Name:NEUHOLD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:361 NE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3111
Mailing Address - Country:US
Mailing Address - Phone:503-260-6299
Mailing Address - Fax:
Practice Address - Street 1:15796 SE MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:OR
Practice Address - Zip Code:97267-3854
Practice Address - Country:US
Practice Address - Phone:503-653-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-101833642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer