Individual
MR. ANDREI JOSEPH ALTAVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 100 CONSONUS HEALTHCARE SERVICES, MILWAUKIE, OR 97222
(971) 206-5149
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100 CONSONUS HEALTHCARE SERVICES, MILWAUKIE, OR 97222
(971) 206-5149
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5160
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5160
LICENSE#
OR
Enumeration date
11/01/2006
Last updated
01/07/2008
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