Individual
AMANDA STOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
(503) 221-3429
(503) 294-3240
Mailing address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4804
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4804
—
OR
Enumeration date
09/17/2010
Last updated
09/17/2010
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