Individual
MARA BIRGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
930 SW HALL ST, PORTLAND, OR 97201
(503) 725-4073
Mailing address
930 SW HALL ST, PORTLAND, OR 97201
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10150281
OR
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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