Healthcare Provider Details

I. General information

NPI: 1619944493
Provider Name (Legal Business Name): EMILY ANNE BAUGHMAN PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 10/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 PHEASANT BLVD STE 100
SPRINGFIELD OR
97477-7509
US

IV. Provider business mailing address

16083 SW UPPER BOONES FERRY RD STE 300
TIGARD OR
97224-7736
US

V. Phone/Fax

Practice location:
  • Phone: 541-736-8870
  • Fax: 541-736-8860
Mailing address:
  • Phone: 800-219-8835
  • Fax: 503-443-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3961
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: