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Individual

CAROLYN A TRAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
12607 SE MILL PLAIN BLVD, MODULE F, VANCOUVER, WA 98684-6055
(360) 944-2813
Mailing address
1115 NE KEYES RD APT D1, VANCOUVER, WA 98684-7360
(360) 944-6869

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7467
OR

Other

Enumeration date
05/21/2008
Last updated
05/21/2008
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