Individual
MARS VINE-HARDING DE PONTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OCCUPATIONAL THERAPI
Contact information
Practice address
1007 SE 12TH AVE, PORTLAND, OR 97214-2512
(206) 240-5956
Mailing address
1007 SE 12TH AVE, PORTLAND, OR 97214-2512
(206) 240-5956
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1035920
OR
225X00000X
Occupational Therapist
OT 00003150
WA
225XP0019X
Physical Rehabilitation Occupational Therapist
1035920
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1035920
OCCUPATIONAL THERAPY LICENSE
OR
Enumeration date
05/09/2007
Last updated
09/17/2018
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