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Individual

JONATHAN DAVID ENG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1001 SE WATER AVE STE 460, PORTLAND, OR 97214-2178
(971) 303-2740
(503) 966-1459
Mailing address
3521 SW COMUS ST, PORTLAND, OR 97219-7561
(202) 744-7693
(503) 966-1459

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60196
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500657096
OR
Enumeration date
05/20/2013
Last updated
01/22/2021
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