Individual
MRS. CASSANDRA LOUISE VAN DOMELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
627 NE EVANS ST, ABACUS PROGRAM, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
627 NE EVANS ST, ABACUS PROGRAM, MCMINNVILLE, OR 97128-3923
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01028937
OR
Other
Enumeration date
04/06/2007
Last updated
02/22/2008
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