Individual
ELIZABETH RA FERTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7150 CORVALLIS RD, INDEPENDENCE, OR 97351-9788
(503) 838-2291
Mailing address
7150 CORVALLIS RD, INDEPENDENCE, OR 97351-9788
(503) 838-2291
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
476804
OR
225XE0001X
Environmental Modification Occupational Therapist
Primary
476804
OR
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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