Individual
MRS. JAMIE CAULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
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
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4402
OR
2251N0400X
Neurology Physical Therapist
4402
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500709568
—
OR
Enumeration date
04/01/2016
Last updated
05/01/2019
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