Individual
ELISA MAUREEN HAWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 331-3050
Mailing address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 331-3050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4776
OR
225100000X
Physical Therapist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022543
—
OR
Enumeration date
12/05/2005
Last updated
03/07/2022
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