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Individual

STEPHANIE CARDELLA BODEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4400 NE HALSEY ST, PORTLAND, OR 97213-1545
(503) 215-6556
Mailing address
13511 SE TAYLOR CT, PORTLAND, OR 97233-1970
(503) 860-8199

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9334
OR

Other

Enumeration date
09/27/2021
Last updated
09/27/2021
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