Individual
DR. LEA CAMILLE DOMINGO KEENANTASKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
377 NW JASPER ST, DALLAS, OR 97338-1279
(503) 623-5581
Mailing address
377 NW JASPER ST, DALLAS, OR 97338-1279
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
65066
OR
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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