Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 347013 | OR |
NPI | 1033410709 |
---|---|
Provider Name | Marta Bogrand |
First Address | Portland, OR 97210-2863 |
Second Address | Portland, OR 97210-2863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2010 |
Last Update Date | 06/02/2013 |