Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A259510 | NY |
NPI | 1013112721 |
---|---|
Provider Name | Dr. Stephanie K Liu |
First Address | Portland, OR 97225 |
Second Address | Portland, OR 97225-5368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 11/09/2015 |