Individual
KRISTEN HASLEBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4444 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3558
(503) 245-5639
Mailing address
1338 NW 106TH TER, PORTLAND, OR 97229-6210
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1042277
OR
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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