Individual
MS. MARY JANE C EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5149 SW 26TH DR, PORTLAND, OR 97239-1230
(503) 314-1827
Mailing address
5149 SW 26TH DRIVE, PORTLAND, OR 97239
(503) 314-1827
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
12/07/2009
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