Individual
ELISABETH THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
70 SW CENTURY DR STE 100, BEND, OR 97702-3558
(808) 990-4823
Mailing address
74-5065 PALANI RD UNIT A, KAILUA KONA, HI 96740-8118
(808) 990-4823
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
09683
OR
225200000X
Physical Therapy Assistant
Primary
333
HI
225200000X
Physical Therapy Assistant
4803
ID
225200000X
Physical Therapy Assistant
60839352
WA
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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