Individual
DR. NANCY PENROD MONNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
16621 CHAMPION WAY, SUITE 100, SANDY, OR 97055-7257
(503) 668-5321
(503) 668-9742
Mailing address
1711 SE 26TH CT, GRESHAM, OR 97080-5291
(503) 667-5880
(503) 669-6555
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1094
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0308
QUAL-MED
OR
05
—
071787
—
OR
01
—
86971
KAISER
OR
01
—
C884 X 0
PACC
OR
Enumeration date
05/15/2007
Last updated
07/09/2007
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