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Individual

SONIA BOUCHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
(503) 221-3429
Mailing address
2232 SE 52ND AVE, PORTLAND, OR 97215-3910
(503) 236-6550

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
681018
OR

Other

Enumeration date
09/08/2010
Last updated
09/08/2010
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