Individual
JOCELYN LEIGH GOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6115 SE HARRISON ST, PORTLAND, OR 97215-3445
(503) 231-6317
Mailing address
6115 SE HARRISON ST, PORTLAND, OR 97215-3445
(503) 231-6317
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0528
OR
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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