Individual
OSCAR RAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
909 SW 18TH AVE, PORTLAND, OR 97205-1705
(503) 297-7678
Mailing address
1470 NW GLISAN ST, PORTLAND, OR 97209-4084
(954) 864-5138
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63571
OR
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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