Individual
MR. NEIL BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, PT
Contact information
Practice address
870 5TH ST, LAKE OSWEGO, OR 97034-2312
(503) 697-0542
(503) 697-4895
Mailing address
870 5TH ST, LAKE OSWEGO, OR 97034-2312
(503) 697-0542
(503) 697-4895
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2021
OR
Other
Enumeration date
12/05/2006
Last updated
10/02/2007
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