Individual
KORY RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
5220 NE HAZEL DELL AVE, VANCOUVER, WA 98663-1242
(360) 693-1474
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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