Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1453 | OR |
NPI | 1134180003 |
---|---|
Provider Name | Mrs. Lesley Elizabeth Freeling |
First Address | Beaverton, OR 97008-6290 |
Second Address | Portland, OR 97239-3843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 08/07/2007 |