Healthcare Provider Details

I. General information

NPI: 1982867198
Provider Name (Legal Business Name): CATHY MARSELLE HURLEY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHY LYNN HAYES PT

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 SE INTERNATIONAL WAY SUITE 100 CONSONUS REHAB SERVICES
MILWAUKIE OR
97222
US

IV. Provider business mailing address

4560 SE INTERNATIONAL WAY SUITE 100 CONSONUS REHAB SERVICES
MILWAUKIE OR
97222
US

V. Phone/Fax

Practice location:
  • Phone: 971-206-5149
  • Fax: 971-206-5209
Mailing address:
  • Phone: 971-206-5149
  • Fax: 971-206-5209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0000607
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: