Individual
MIRANDA BOYTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
(503) 761-1155
Mailing address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215527
TX
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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