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Individual

VICTORIA BRYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
20055 SW PACIFIC HWY, SUITE 110, SHERWOOD, OR 97140-9294
(503) 625-1691
(503) 925-1460
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60041
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500657071
OR
01
P01491759
RR MEDICARE PTAN
OR
Enumeration date
05/07/2013
Last updated
02/09/2016
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