Individual
LORI AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
319 NE RUSSET ST, PORTLAND, OR 97211-2815
(503) 289-5571
Mailing address
319 NE RUSSET ST, PORTLAND, OR 97211-2815
(503) 289-5571
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09634
OR
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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