Individual
ISAIAH BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
6040 SE BELMONT ST, PORTLAND, OR 97215-1974
(503) 231-7166
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
413578
OR
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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