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Individual

JEFFERY WARILA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
17316 NE HALSEY ST, PORTLAND, OR 97230-6026
(503) 257-6623
(503) 257-6624
Mailing address
17316 NE HALSEY ST, PORTLAND, OR 97230-6026
(503) 257-6623
(503) 257-6624

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297519
OR
Enumeration date
05/29/2015
Last updated
05/29/2015
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