Individual
GLORIA M BENCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,P.T.
Contact information
Practice address
16955 OLD RIVER DR, LAKE OSWEGO, OR 97034-5118
(503) 675-9760
Mailing address
16955 OLD RIVER DR, LAKE OSWEGO, OR 97034-5118
(503) 675-9760
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3559
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3559
PT STATE LICENSURE
OR
Enumeration date
03/27/2007
Last updated
07/08/2007
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