Individual
JORDAN VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-1234
Mailing address
45 EAGLE CREST DR APT 216, LAKE OSWEGO, OR 97035-1051
(513) 543-3843
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62421
OR
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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