Individual
ANN MARIKO BOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(503) 570-3665
(503) 570-9155
Mailing address
290 CAMBRIDGE ST, ASHLAND, OR 97520-1002
(541) 951-8390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4154
OR
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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