Individual
JOANNE MYRA VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6040 SE BELMONT ST, PORTLAND, OR 97215-1974
(503) 231-2166
Mailing address
4560 SE INTERNATIONAL WAY, #100, PORTLAND, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
297003
OR
Other
Enumeration date
03/22/2016
Last updated
03/23/2016
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