Individual
MISS ALYSSA NICOLE CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2200
Mailing address
1340 NE KILLINGSWORTH ST APT B1, PORTLAND, OR 97211-4387
(650) 918-9102
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
13454
CA
225X00000X
Occupational Therapist
Primary
306629
OR
Other
Enumeration date
03/31/2014
Last updated
01/05/2021
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