Individual
MRS. JILL MARIE RALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
75 SHORE DR, SAINT HELENS, OR 97051-1125
(503) 397-2720
(503) 397-2669
Mailing address
16057 NW GRAF ST, PORTLAND, OR 97229-9213
(503) 645-8434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4576
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029043
—
OR
Enumeration date
07/10/2007
Last updated
07/10/2007
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