Individual
ANDREA JANE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2701 NW VAUGHN ST, STE 140, PORTLAND, OR 97210-5311
(503) 499-5200
(503) 499-5213
Mailing address
6411 SW 25TH AVE, PORTLAND, OR 97239-1982
(503) 244-4283
(503) 452-7745
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
234039
PA
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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