Provider Demographics
NPI:1386094936
Name:METZAR, LESLIE (PTA)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:METZAR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:FILOSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10045 SW 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-8028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10045 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-8028
Practice Address - Country:US
Practice Address - Phone:503-705-8287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR09326225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant