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Organization
BOLD PEDIATRIC THERAPY CENTER INC
Active
Organization
BOLD PEDIATRIC THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA PELHAM-FOSTER OTD, MPHA, OTR/L (DIRECTOR /OWNER)
(503) 313-7333
Entity
Organization
Contact information
Practice address
1815 NW 169TH PL STE 3070, BEAVERTON, OR 97006-7368
(971) 249-2653
Mailing address
409 NE BIRCHWOOD TER, HILLSBORO, OR 97124-3219
15033137333
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
OR
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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