Individual
JILL KATHERINE BEAUREGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
(971) 978-1268
Mailing address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
(971) 978-1268
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
465900
OR
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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