Individual
MRS. HANNEKE JAMIESON HOLDERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5701 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3195
(503) 244-1107
Mailing address
5701 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3195
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0730113076
VT
Other
Enumeration date
11/07/2006
Last updated
03/03/2017
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