Individual
AMY LEIGH OUELLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
21178 SW LADYFERN DR, SHERWOOD, OR 97140-8955
(541) 399-6961
(503) 405-7448
Mailing address
21178 SW LADYFERN DR, SHERWOOD, OR 97140-8955
(541) 399-6961
(503) 405-7448
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5105
OR
2251P0200X
Pediatric Physical Therapist
Primary
5105
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005727
—
OR
Enumeration date
02/01/2006
Last updated
09/17/2024
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