Individual
MRS. ANGELA CORVERA CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S. P.T.
Contact information
Practice address
2701 NW VAUGHN ST, PORTLAND, OR 97210-5311
(503) 721-6800
Mailing address
2701 NW VAUGHN ST, PORTLAND, OR 97210-5311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15088
CA
225100000X
Physical Therapist
Primary
4705
OR
225100000X
Physical Therapist
4863
CO
225100000X
Physical Therapist
PT00009440
WA
Other
Enumeration date
08/22/2006
Last updated
12/27/2021
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