Individual
LAI NIIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
2701 NW VAUGHN ST, STE 140, PORTLAND, OR 97210-5311
(503) 499-5200
Mailing address
2701 NW VAUGHN ST, STE 140, PORTLAND, OR 97210-5311
(503) 499-5200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5877
OR
Other
Enumeration date
03/11/2009
Last updated
03/11/2009
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