Individual
MRS. DIANYS VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
16 NE 85TH AVE, PORTLAND, OR 97220-5901
(503) 257-6909
Mailing address
16 NE 85TH AVE, PORTLAND, OR 97220-5901
(503) 257-6909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1239
OR
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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