Healthcare Provider Details

I. General information

NPI: 1134180003
Provider Name (Legal Business Name): LESLEY ELIZABETH FREELING PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 SW MACADAM AVE
PORTLAND OR
97239-3843
US

IV. Provider business mailing address

7925 SW 135TH AVE
BEAVERTON OR
97008-6290
US

V. Phone/Fax

Practice location:
  • Phone: 503-224-1998
  • Fax: 503-224-5176
Mailing address:
  • Phone: 503-644-1988
  • Fax: 503-626-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1453
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: