| Doctor Name: | MRS. ASHLEE NICOLE RODERICK |
| NPI Number: | 1841679883 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT, PT, CPT |
| License Number: | 61070 |
| Business Practice Address: | 732 Main St Philomath, OR - 973709725 |
| Business Phone Number: | 5419292255 |
| Business Fax Number: | |
| Mailing Address: | 815 Takena St Sw, ALBANY |
| State: | OR |
| Postal Code: | 973212068 |
| Phone Number: | 5307133002 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2015 |
| NPI Last Update Date: | 05/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 61070 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |