Individual
SHANE DURANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20055 SW PACIFIC HWY, SUITE 110, SHERWOOD, OR 97140-9294
(503) 625-1691
(503) 925-1460
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61856
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715189
—
OR
Enumeration date
08/03/2016
Last updated
01/25/2017
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