Individual
MRS. MARY TENNEY QUIBRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 768-5048
Mailing address
3656 SE MIDVALE DR, CORVALLIS, OR 97333-3229
(541) 752-6970
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1039091
OR
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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