Individual
JULIET ALLISON KORNGUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD STE 200, TIGARD, OR 97224-7259
(503) 216-0686
(503) 216-0831
Mailing address
1261 NW OVERTON ST APT 1807, PORTLAND, OR 97209-3899
(214) 662-5161
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
295139
OR
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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