Individual
ANTONIA S GUSTAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
19365 SW 65TH AVE, TUALATIN, OR 97062-9196
(503) 692-5210
Mailing address
1115 SE MALDEN ST, PORTLAND, OR 97202-5933
(312) 622-0391
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
48499
OR
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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