Individual
JUNE SUPARATANA SRISETHNIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
14010 NW TRADEWIND ST, PORTLAND, OR 97229-2445
(650) 451-2245
Mailing address
14010 NW TRADEWIND ST, PORTLAND, OR 97229-2445
(650) 451-2245
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
32269
CA
225100000X
Physical Therapist
Primary
64358
OR
225100000X
Physical Therapist
CP014326T
TX
225100000X
Physical Therapist
CP022075T
NC
225100000X
Physical Therapist
CP022096T
VA
Other
Enumeration date
12/08/2006
Last updated
07/13/2023
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