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Individual
MABELLE CHAN MENDOZA
Active
Individual
MABELLE CHAN MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62768
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62768
STATE OF OREGON PHYSICAL THERAPIST LICENSING BOARD
OR
Enumeration date
05/29/2018
Last updated
05/29/2018
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