Individual
NATHANIEL NAZARENO BANIQUED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
5825 NE RAY CIR, HILLSBORO, OR 97124-6436
(503) 614-1428
Mailing address
5825 NE RAY CIR, HILLSBORO, OR 97124-6436
(503) 614-1428
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
502920
OR
Other
Enumeration date
09/09/2018
Last updated
11/09/2023
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