Individual
JENNIFER ANN OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
12441 SE STARK ST, PORTLAND, OR 97233-1053
(503) 255-7040
Mailing address
5880 ROCKWOOD CT, LAKE OSWEGO, OR 97035-4146
(503) 534-2761
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8004
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8004
—
OR
Enumeration date
08/15/2008
Last updated
08/15/2008
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