Individual
PAUL SONG EO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
24076 SE STARK ST STE 200, GRESHAM, OR 97030-3376
(503) 491-1666
Mailing address
2737 NW UPSHUR ST APT 218, PORTLAND, OR 97210-2273
(224) 616-1199
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63730
OR
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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