Individual
MRS. MISTY PORTASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
19304 SE RIVER DRIVE CT, MILWAUKIE, OR 97267-6856
(503) 654-3539
Mailing address
19304 SE RIVER DRIVE CT, MILWAUKIE, OR 97267-6856
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7317
OR
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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