Individual
NICOLE LEE LANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10220 SW GREENBURG RD STE 201, TIGARD, OR 97223-5505
(503) 570-3665
Mailing address
5022 SW SLAVIN RD APT 19, PORTLAND, OR 97239-2838
(503) 704-3140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8369
OR
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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