Individual
MR. SAM VASQUEZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
626 SE 9TH AVE, HILLSBORO, OR 97123-4600
(503) 681-4238
(503) 681-4239
Mailing address
1320 SW CHELTENHAM ST., #3, PORTLAND, OR 97239-7020
(503) 681-4238
(503) 681-4239
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-949393
OR
Other
Enumeration date
06/14/2006
Last updated
07/08/2007
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