Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 302 | OR |
NPI | 1003026154 |
---|---|
Provider Name | Ms. Ruth A Hurst |
First Address | Portland, OR 97219-1725 |
Second Address | Portland, OR 97219-1725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |