Individual
MS. CAMPBELL MIKUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(503) 228-6479
Mailing address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(503) 228-6479
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
324129
OR
Other
Enumeration date
04/10/2014
Last updated
07/27/2015
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