Individual
LAUREN ALEXIS CALVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
830 NE 47TH AVE, PORTLAND, OR 97213
(503) 215-2233
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61665
OR
2251P0200X
Pediatric Physical Therapist
61665
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719172
—
OR
Enumeration date
08/11/2016
Last updated
09/28/2020
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