Individual
TIA PUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9155 S.W. BARNES ROAD, EAST PAVILION, PORTLAND, OR 97225
(503) 216-2339
Mailing address
9155 S.W. BARNES ROAD, EAST PAVILION, PORTLAND, OR 97225
(503) 216-2339
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1054300
OR
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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