Individual
REBECCA KRISTINE HANNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
9625 SW 125TH AVE, BEAVERTON, OR 97008-7755
(503) 259-5400
Mailing address
17998 NW FAYE CT, BEAVERTON, OR 97006-4174
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-356687
OR
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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