Provider Demographics
NPI:1912989047
Name:PRIEST, VALERIE JEAN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:PRIEST
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:JEAN
Other - Last Name:SABAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:3303 SW BOND ST.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-494-3151
Mailing Address - Fax:503-494-3151
Practice Address - Street 1:10215 SW PARKWAY
Practice Address - Street 2:STE D
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5036
Practice Address - Country:US
Practice Address - Phone:503-292-3583
Practice Address - Fax:503-292-1022
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IL070009248225100000X
OR3784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR295707Medicaid
OR106235Medicare PIN