Individual
MR. TONY J CORNEJO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTAL
Contact information
Practice address
4560 SE INTERNATIONAL WAY, CONSONUS HEALTHCARE SERVICES SUITE 100, MILWAUKIE, OR 97222
(971) 206-5149
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, CONSONUS HEALTHCARE SERVICES SUITE 100, MILWAUKIE, OR 97222
(971) 206-5149
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC00000791
WA
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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