Individual
SEAN ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHP
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
457 NW DYREKA CT, MCMINNVILLE, OR 97128-5338
(503) 434-7523
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1027632
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1027632
OCCUPATIONAL THERAPIST
OR
Enumeration date
02/12/2007
Last updated
07/08/2007
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