Individual
MS. GWEN MARIE HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1130 NW 22ND AVE STE 345, PORTLAND, OR 97210-2978
(503) 413-7513
(503) 413-7503
Mailing address
1650 NW NAITO PKWY STE 185, PORTLAND, OR 97209-2535
(503) 525-7600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5417
OR
Other
Enumeration date
06/29/2007
Last updated
03/18/2020
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