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Individual

ADAM ZACKER KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
16195 SW 72ND AVE, PORTLAND, OR 97224-7766
(503) 619-1020
Mailing address
22448 SW 104TH AVE, TUALATIN, OR 97062-7595
(503) 780-5613

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5059
OR

Other

Enumeration date
03/07/2008
Last updated
01/03/2011
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