Individual
ANNABELLE TY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1778 NE CORNELL RD, HILLSBORO, OR 97124-2740
(503) 648-6621
Mailing address
21726 SW SUSAN LN, BEAVERTON, OR 97003-6588
(916) 220-0846
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5589
OR
225100000X
Physical Therapist
PT 30315
CA
Other
Enumeration date
12/06/2006
Last updated
07/21/2022
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