Individual
JEFFREY ALLEN CUSUMANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 NW VAUGHN ST, PORTLAND, OR 97210-5311
(503) 499-5200
Mailing address
2701 NW VAUGHN ST STE 140, PORTLAND, OR 97210-5344
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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