Individual
KEVIN QUANGKIEN MAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(035) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
431857
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431857
OT LICENSE
OR
Enumeration date
05/08/2019
Last updated
01/09/2020
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