Individual
ANDREA KATHRYN KUEBBING MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222
(971) 206-5202
Mailing address
2257 SE 43RD AVE, PORTLAND, OR 97215-3711
(503) 960-3047
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
225100000X
Physical Therapist
Primary
62722
OR
Other
Enumeration date
01/18/2012
Last updated
06/11/2018
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