Individual
ASHLEY MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1650 THOMPSON RD, COOS BAY, OR 97420-2170
(541) 269-7212
Mailing address
1650 THOMPSON RD, COOS BAY, OR 97420-2170
(541) 269-7212
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61697
OR
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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