Individual
THERON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1475 SE 100TH AVE, PORTLAND, OR 97216-2537
(503) 262-6000
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62547
OR
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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