Individual
MONIKA RENEE DESHAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 NE 201ST AVE, FAIRVIEW, OR 97024-2499
(503) 661-7200
Mailing address
21021 SE BURNSIDE CT, GRESHAM, OR 97030-3643
(503) 381-9981
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8850
OR
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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