Individual
IVY GABRIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11850 SW ALLEN BLVD, BEAVERTON, OR 97005-4805
(206) 355-9261
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(206) 355-9261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9458
OR
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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