Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1326406851 |
---|---|
Provider Name | Jaclyn Sinauskas |
First Address | Portland, OR 97206-5542 |
Second Address | Portland, OR 97236-4601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2016 |
Last Update Date | 28/01/2016 |