Individual
SHAWN GIRDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
551 LONE PINE BLVD, THE DALLES, OR 97058-9403
(541) 296-7202
Mailing address
1315 E 19TH ST, THE DALLES, OR 97058-3345
(541) 980-8876
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8550
OR
Other
Enumeration date
06/06/2021
Last updated
06/06/2021
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