Individual
MR. VLADISLAV L POLEVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
6040 SE BELMONT ST, PORTLAND, OR 97215
(971) 206-5200
(971) 206-5203
Mailing address
4560 SE INTERNATIONAL WAY, STE. 100, CONSONUS HEALTHCARE SERVICES ATTN: ANNA BROWNE, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
222390
OR
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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