Individual
MRS. CARRIE AMANDA LUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSR, OT/L, ATP
Contact information
Practice address
2100 NE BROADWAY STE 119, PORTLAND, OR 97232-1500
(503) 312-3348
(503) 536-6733
Mailing address
2315 NE 40TH AVE, PORTLAND, OR 97212-5418
(503) 312-3348
(503) 536-6733
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1053229
OR
Other
Enumeration date
02/14/2011
Last updated
09/23/2011
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