Individual
MINI GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30459 SW ROGUE LN UNIT 5212, WILSONVILLE, OR 97070-6686
(425) 324-7129
Mailing address
20015 SW 63RD TER, TUALATIN, OR 97062-8949
(503) 960-2060
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62558
OR
Other
Enumeration date
12/18/2017
Last updated
05/06/2020
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