Individual
JENNIFER RHAE HAUNOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1815 SW MARLOW, STE 110, PORTLAND, OR 97225-5185
(503) 292-0765
(503) 292-5208
Mailing address
1815 SW MARLOW, STE 110, PORTLAND, OR 97225-5185
(503) 292-0765
(503) 292-5208
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06001
OR
Other
Enumeration date
08/11/2009
Last updated
08/26/2009
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