Individual
JILL VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-1234
Mailing address
15370 SW MALLARD DR STE 105, BEAVERTON, OR 97007-9430
(503) 956-6059
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1075199
OR
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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