Individual
LACEY KREBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 NE 47TH AVE, PORTLAND, OR 97213-2236
(503) 215-1077
Mailing address
507 NE 47TH AVE, PORTLAND, OR 97213-2236
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
61064
OR
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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