Individual
JASON JEREMY VILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
101 S STATE ST, SUITE 200G, LAKE OSWEGO, OR 97034-3900
(503) 636-3028
(503) 636-1837
Mailing address
101 S STATE ST, SUITE 200G, LAKE OSWEGO, OR 97034-3900
(503) 636-3028
(503) 636-1837
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4201
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232010
—
OR
Enumeration date
03/14/2006
Last updated
05/09/2008
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