Individual
MS. GWENDOLYN MAE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 331-3050
Mailing address
4401 SW 40TH AVE, PORTLAND, OR 97221-4017
(503) 294-0152
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0572
OR
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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