Individual
LISA A HARTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3457 NE DIVISION ST, GRESHAM, OR 97030-4602
(503) 667-1965
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(888) 757-3422
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8373
OR
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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