Individual
MRS. MARCEEA GENEA HANLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
19250 SW 65TH AVE, MEDICAL PLAZA #1, SUITE 125, TUALATIN, OR 97062-7452
(503) 692-1670
(503) 692-1669
Mailing address
PO BOX 4037, PORTLAND, OR 97208-4037
(503) 413-4048
(503) 413-2910
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT03467
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03467
OREGON STATE LICENSE
OR
05
—
PENDING
—
OR
Enumeration date
05/19/2011
Last updated
06/09/2011
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