Individual
DEBBIE LEE FASTENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
201 NE PARK PLAZA DR STE 246, VANCOUVER, WA 98684-5874
(360) 696-1070
(360) 737-0200
Mailing address
50136 SE WEBER RD, SANDY, OR 97055-7420
(503) 668-9239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7662
OR
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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