Individual
MRS. KATHY SMITH WIJAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-2091
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
(855) 524-5255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4057
OR
Other
Enumeration date
09/02/2012
Last updated
10/01/2025
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