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Individual

KEITH JEROME LASKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
501 N DIXON ST, PORTLAND, OR 97227-1876
(503) 916-2000
Mailing address
501 N DIXON ST, PORTLAND, OR 97227-1876
(503) 916-2000

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06115
OR

Other

Enumeration date
06/12/2024
Last updated
06/12/2024
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