Individual
ANDREA LACOURSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
205 NE 156TH AVE, PORTLAND, OR 97230-4816
(607) 351-9910
Mailing address
205 NE 156TH AVE, PORTLAND, OR 97230-4816
(607) 351-9910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
303124
OR
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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