Individual
LISA WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1577 S IVY ST, CANBY, OR 97013-4334
(503) 266-5541
Mailing address
4560 SE INTERNATIONAL WAY, MILWAUKIE, OR 97222-4628
(971) 206-5202
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
475020
OR
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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