Individual
REBEKAH COLASURDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4690 SW WASHINGTON AVE, BEAVERTON, OR 97005-0530
(503) 644-3311
(503) 627-0112
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62272
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500725581
—
OR
01
—
R195402
MEDICARE
OR
Enumeration date
05/22/2017
Last updated
07/31/2017
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