Elizabeth Bolte, PT
Individual provider Active NPI Physical Therapist · Philomath, OR
NPI 1285774075 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285774075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1475 (OR)
- Practice address
- 111 N 20TH St
Philomath, OR 97370-9621 - Phone
- (541) 368-4313
- Fax
- (541) 929-4967
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1475 | OR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Professionals Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1475 | OR | Yes |
Addresses
Primary practice location
111 N 20TH St
Philomath, OR 97370-9621
Mailing address
PO Box 455
Philomath, OR 97370-0455
Phone (541) 368-4313
Other providers in Philomath, OR
- Charles F. Baker
- Taylor Bennion
- Benton County School Dist 17J
- Lawrence Austin Birch
- Curtis Legrand Black
- Rebecca Bricker
- Cassandra Anne Brown
- Lisa Burner
- Clear Path
- Clear Path Center, P.a.
All providers in Philomath, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.