Individual
VALERIE RENEE PONTIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
23000 SW PACIFIC HWY, SHERWOOD, OR 97140-8061
(503) 318-1129
Mailing address
8488 SW MOHAWK ST, TUALATIN, OR 97062-9135
(503) 318-1129
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10329
OR
171W00000X
Contractor
MA00021696
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0209123
LABOR & INDUSTRIES
WA
01
—
912075994-09
KPS HEALTH PLANS
WA
Enumeration date
05/24/2007
Last updated
04/10/2011
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