Individual
EMILY KOSDERKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2811 NE HOLMAN ST, PORTLAND, OR 97211-6067
(503) 280-8525
Mailing address
28825 SW GRAHAMS FERRY RD, WILSONVILLE, OR 97070-9516
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0975249
NATA
OR
Enumeration date
12/28/2018
Last updated
12/28/2018
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