| Doctor Name: | LESLEY ANN DEFAZIO |
| NPI Number: | 1447498886 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 5827 |
| Business Practice Address: | 519 Nw Division St Suite 220 Gresham, OR - 970305527 |
| Business Phone Number: | 5036667644 |
| Business Fax Number: | 5036749980 |
| Mailing Address: | 11481 Sw Hall Blvd, Suite 201 PORTLAND |
| State: | OR |
| Postal Code: | 972238403 |
| Phone Number: | 8002198835 |
| Fax Number: | 5036399699 |
| NPI Enumeration Date: | 01/22/2009 |
| NPI Last Update Date: | 07/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5827 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |