Individual
AUDREY R ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1114 GEORGIANA ST, PORT ANGELES, WA 98362-4212
(360) 452-6216
(360) 452-8765
Mailing address
11481 SW HALL BLVD, SUITE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60095069
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0252228
WASHINGTON L & I
WA
05
—
1689804957
—
WA
01
—
P00802461
RR MEDICARE
WA
Enumeration date
07/21/2009
Last updated
05/14/2010
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