Individual
ELSPETH PERCIVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12045 SE STANLEY AVE, PORTLAND, OR 97222-2938
(503) 659-2323
Mailing address
5614 NE 34TH AVE, PORTLAND, OR 97211-7418
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09372
OR
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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