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Individual

JODIE MAE ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
20055 SW PACIFIC HWY, STE 110, SHERWOOD, OR 97140-9294
(503) 625-1691
(503) 926-1460
Mailing address
1700 BROADWAY ST., VANCOUVER, WA 98663
(360) 737-3346
(360) 694-7356

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5033
OR
225100000X
Physical Therapist
Primary
PT60119188
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269836
OR
Enumeration date
11/16/2005
Last updated
08/25/2010
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