Individual
PIERRE SOUBRIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1844 SW MORRISON ST, PORTLAND, OR 97205-1605
(203) 804-9433
Mailing address
6207 SW DOLPH DR, PORTLAND, OR 97219-4949
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10196910
OR
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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