Provider Demographics
NPI:1750365789
Name:SPANIOL TURNER, JUDY ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ELIZABETH
Last Name:SPANIOL TURNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ELIZABETH
Other - Last Name:SPANIOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:14230 NE MILTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-3641
Mailing Address - Country:US
Mailing Address - Phone:503-256-7800
Mailing Address - Fax:
Practice Address - Street 1:2230 NW PETTYGROVE ST STE 140
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2688
Practice Address - Country:US
Practice Address - Phone:503-512-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1499225100000X
WAPT00005205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8371080Medicaid
ORR134948Medicare PIN
WAAB39293Medicare ID - Type Unspecified
ORR155509Medicare PIN