Provider Demographics
NPI:1053609735
Name:BOYD, PATRICIA IRENE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:IRENE
Last Name:BOYD
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:IRENE
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:3889 SE LICYNTRA LN
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6058
Mailing Address - Country:US
Mailing Address - Phone:503-653-1331
Mailing Address - Fax:
Practice Address - Street 1:3889 SE LICYNTRA LN
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6058
Practice Address - Country:US
Practice Address - Phone:503-653-1331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist