Individual
TASJA DUBENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4616 N ALBINA AVE, PORTLAND, OR 97217-3012
(503) 335-9980
Mailing address
5558 RADELL DR SE, SALEM, OR 97317-9145
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
389249
OR
Other
Enumeration date
08/18/2018
Last updated
08/18/2018
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