Individual
MISS SAMANTHA E KREIZENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2155 NW 173RD AVE, SUITE 103, BEAVERTON, OR 97006-3563
(503) 352-0735
Mailing address
16784 SW VINCENT ST, ALOHA, OR 97007-1912
(503) 464-6410
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
16765
OR
Other
Enumeration date
05/17/2011
Last updated
10/04/2013
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