Individual
JANE OBERMILLER SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6010 SW SHATTUCK RD, PORTLAND, OR 97221-1043
(503) 246-8811
Mailing address
4560 SE INTERNATIONAL WAY, MILWAUKIE, OR 97222-4628
(503) 341-9281
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09388
OR
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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