Individual
ROSE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 NE 5TH ST, GRESHAM, OR 97030-7345
(503) 666-5600
Mailing address
15121 SW MILLIKAN WAY APT 318, BEAVERTON, OR 97003-5191
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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