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Individual

MS. MARIE JOSETTE FAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
5701 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3195
(503) 977-1796
(503) 977-1796
Mailing address
14130 SW BARROWS RD APT 1, TIGARD, OR 97223-5748
(503) 579-0168

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3327
OR
225100000X
Physical Therapist
9929
CA

Other

Enumeration date
07/10/2007
Last updated
07/10/2007
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