Individual
REBECCA GUBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT,CNT
Contact information
Practice address
1932 SE 44TH AVE, PORTLAND, OR 97215-3129
(503) 239-0164
Mailing address
1932 SE 44TH AVE, PORTLAND, OR 97215-3129
(503) 239-0164
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18260
OR
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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