Individual
JOHANKA STAVENIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5701 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3195
(503) 244-1107
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(971) 224-2004
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
—
—
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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