Individual
DOUGLAS NOLAND BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Contact information
Practice address
25030 SW PARKWAY AVE STE 100, WILSONVILLE, OR 97070-9816
(503) 582-1073
(503) 582-1093
Mailing address
13525 SW ARAGON ST, BEAVERTON, OR 97005-0820
(971) 570-6818
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62607
OR
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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