Individual
TARA LYNN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
16485 SW PACIFIC HWY, TIGARD, OR 97224-3446
(503) 620-5141
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1076568
OR
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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