Provider Demographics
NPI:1386260073
Name:BELT, COURTNEY JEAN (DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JEAN
Last Name:BELT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7743 SE 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-8050
Mailing Address - Country:US
Mailing Address - Phone:480-323-0377
Mailing Address - Fax:
Practice Address - Street 1:220 E HEREFORD ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2165
Practice Address - Country:US
Practice Address - Phone:503-656-0393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63276208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation