Individual
MRS. JOANNA E MULLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
270 NW BURNSIDE RD, GRESHAM, OR 97030-3836
(503) 215-9141
Mailing address
5609 SE 48TH AVE, PORTLAND, OR 97206-5620
(503) 774-4339
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4068
OR
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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