Individual
NANCYBETH BANASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5050 NE HOYT ST, PORTLAND, OR 97213-2991
(503) 215-6488
(503) 215-6485
Mailing address
13704 SE STEELE ST, PORTLAND, OR 97236-4074
(503) 762-3462
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4045
OR
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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