Individual
MICHAEL OXENTENKO II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5905 SE POWELL VALLEY RD, GRESHAM, OR 97080-1919
(503) 665-1151
(503) 669-1986
Mailing address
43131 SE MUSIC CAMP RD, SANDY, OR 97055-8463
(503) 665-1151
(503) 669-1986
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1040
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025176
—
OR
Enumeration date
03/22/2007
Last updated
07/08/2007
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