Individual
SYDNEY FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1750 WILCO RD, STAYTON, OR 97383
(503) 769-7131
(503) 769-7132
Mailing address
2675 NE LANCASTER ST APT 76, CORVALLIS, OR 97330-4144
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
337582
OR
Other
Enumeration date
06/07/2016
Last updated
08/29/2018
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