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Individual

DANA M BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10401 NE FOURTH PLAIN RD, SUITE 101, VANCOUVER, WA 98662-6308
(360) 892-5142
(360) 892-2157
Mailing address
3801 SE MORRISON ST, #3, PORTLAND, OR 97214-3200

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TL10000766
WA

Other

Enumeration date
01/30/2007
Last updated
07/08/2007
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