Individual
JESSICA MADDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
6105 SE 45TH AVE, PORTLAND, OR 97206-7026
(650) 740-3734
Mailing address
6105 SE 45TH AVE, PORTLAND, OR 97206-7026
(650) 740-3734
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63614
OR
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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