Individual
CHRISTIAN RICARDO MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
200 S HAZEL DELL WAY STE 210, CANBY, OR 97013-7828
(503) 263-9550
Mailing address
8833 SW 30TH AVE APT 116, PORTLAND, OR 97219-4066
(503) 422-7816
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
63269
OR
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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