Individual
MISS BHAVANA RAMASAHAYAM REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11782 SW BARNES RD STE 100, PORTLAND, OR 97225-5931
(503) 906-4323
(503) 906-6613
Mailing address
11782 SW BARNES RD STE 100, PORTLAND, OR 97225-5931
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5225
OR
2251X0800X
Orthopedic Physical Therapist
5225
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500611946
—
OR
01
—
5225
PT LICENSE
OR
Enumeration date
08/18/2008
Last updated
05/25/2021
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