Individual
JESSICA K LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2120 EXCHANGE ST, SUITE 104, ASTORIA, OR 97103-3366
(503) 325-7711
(503) 325-7143
Mailing address
2120 EXCHANGE ST, SUITE 104, ASTORIA, OR 97103-3366
(503) 325-7711
(503) 325-7143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09087
OR
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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