Individual
JESUS C. MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Contact information
Practice address
10151 SE SUNNYSIDE RD STE 310, CLACKAMAS, OR 97015-6913
(503) 496-1058
(888) 675-5282
Mailing address
10151 SE SUNNYSIDE RD STE 310, CLACKAMAS, OR 97015-6913
(503) 496-1058
(888) 675-5282
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5547
OR
Other
Enumeration date
11/03/2007
Last updated
12/16/2009
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