Organization
FUNCTION THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HILLARY INGRID KIBGIS OTR/L (OWNER)
(503) 922-9895
Entity
Organization
Contact information
Practice address
7925 SE STARK ST, PORTLAND, OR 97215-2341
(503) 922-9895
Mailing address
PO BOX 86745, PORTLAND, OR 97286
(503) 922-9895
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
1069622
OR
Other
Enumeration date
07/02/2015
Last updated
10/27/2017
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