Provider Demographics
NPI:1427291764
Name:BUFFINGTON, ASHLEY WILDER (DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:WILDER
Last Name:BUFFINGTON
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 1:745 SW HILARY ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6918
Mailing Address - Country:US
Mailing Address - Phone:503-472-0096
Mailing Address - Fax:
Practice Address - Street 1:745 SW HILARY ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6918
Practice Address - Country:US
Practice Address - Phone:503-472-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist