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Individual

MS. JANA LYNN PORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
11300 NE HALSEY ST, SUITE 102, PORTLAND, OR 97220-2096
(503) 257-9881
(503) 257-8964
Mailing address
4920 NE GLISAN ST, #416, PORTLAND, OR 97213-2963
(503) 239-7523

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7673
OR

Other

Enumeration date
07/24/2006
Last updated
07/08/2007
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