Individual
MADISON JOHANNA COCKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
304 NE HOOD AVE, GRESHAM, OR 97030-7450
(503) 666-1333
Mailing address
304 NE HOOD AVE, GRESHAM, OR 97030-7450
(503) 666-1333
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
65297
OR
Other
Enumeration date
06/13/2024
Last updated
03/24/2025
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