Organization
PEDIATRIC SENSORY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GOULD-YORK MOT, OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(503) 477-9527
Entity
Organization
Contact information
Practice address
6635 N BALTIMORE AVE, SUITE 228, PORTLAND, OR 97203-5454
(503) 477-9527
Mailing address
6635 N BALTIMORE AVE, SUITE 228, PORTLAND, OR 97203-5454
(503) 477-9527
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1076095
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273905
—
OR
Enumeration date
07/19/2012
Last updated
07/19/2012
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