Individual
VICKIE PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17540 BROWN RD, DALLAS, OR 97338-9375
(503) 949-1449
Mailing address
17540 BROWN RD, DALLAS, OR 97338-9375
(503) 949-1449
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
333228
OR
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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