Individual
ELISE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 NE FREMONT ST, PORTLAND, OR 97212-1952
(503) 493-4463
Mailing address
18450 NE RIBBON RIDGE RD, NEWBERG, OR 97132-6566
(503) 476-2511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63874
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299256
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
01
—
63874
STATE OF OREGON BOARD OF PHYSICAL THERAPY
OR
Enumeration date
11/06/2020
Last updated
11/06/2020
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