Individual
AMY BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T
Contact information
Practice address
2035 NW FRONT AVE FL 2, PORTLAND, OR 97209-2177
(503) 308-1332
(503) 850-9021
Mailing address
2035 NW FRONT AVE FL 2, PORTLAND, OR 97209-2177
(503) 308-1332
(503) 850-9021
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5760
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500601822
—
OR
01
—
P01322188
RR
OR
Enumeration date
10/15/2008
Last updated
11/21/2024
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