Individual
MS. ELLEN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1328 N ALBERTA ST, PORTLAND, OR 97217-3704
(508) 733-3358
Mailing address
1328 N ALBERTA ST, PORTLAND, OR 97217-3704
(508) 733-3358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63950
OR
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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