Individual
ELIZABETH LEAH BLACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
5050 NE HOYT ST STE 315, PORTLAND, OR 97213-2982
(503) 215-8580
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61919
OR
Other
Enumeration date
07/30/2018
Last updated
12/13/2019
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