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Individual

JULIE E TEAL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2330 NW FLANDERS ST, STE G-1, PORTLAND, OR 97210-3442
(503) 224-9270
(503) 224-9271
Mailing address
2330 NW FLANDERS ST, STE G-1, PORTLAND, OR 97210-3442
(503) 224-9270
(503) 224-9271

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
393462
OR
225XH1200X
Hand Occupational Therapist
OT00002214
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0055250
WA L&I
WA
05
021423
OR
05
8434615
WA
Enumeration date
11/28/2005
Last updated
07/09/2007
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