Individual
SASCHA ANN GERVAIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3615 SPICER DR SE, ALBANY, OR 97322-7043
(541) 967-7551
(541) 967-5095
Mailing address
3615 SPICER DR SE, ALBANY, OR 97322-7043
(541) 967-7551
(541) 967-5095
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4469
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297922
—
OR
01
—
A002
TRICARE
OR
01
—
B060407
PACIFICSOURCE
OR
Enumeration date
05/17/2006
Last updated
07/09/2007
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