Individual
STACEY L COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5420 NE GLISAN ST, PORTLAND, OR 97213-3063
(503) 233-3163
(503) 238-4553
Mailing address
2424 NE 19TH AVE, PORTLAND, OR 97212-4252
(503) 720-9500
(503) 238-4553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4207
OR
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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