Provider Demographics
NPI:1669799433
Name:ELSBERRY, ALISON (OTR/L)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:ELSBERRY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 SW 17TH ST
Mailing Address - Street 2:SUITE# 202
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2572
Mailing Address - Country:US
Mailing Address - Phone:208-507-0199
Mailing Address - Fax:
Practice Address - Street 1:916 SW 17TH ST
Practice Address - Street 2:SUITE# 202
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2572
Practice Address - Country:US
Practice Address - Phone:541-504-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1040682225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist