Individual
JESSICA HOPE SHIYOMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
13590 NW MAIN STREET, BANKS, OR 97106
(971) 713-3960
(971) 713-3966
Mailing address
13590 NW MAIN STREET, BANKS, OR 97106
(971) 713-3960
(971) 713-3966
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60689
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
861165534
—
OR
Enumeration date
08/22/2016
Last updated
02/01/2021
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