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1104396589
REBECCA-KELLY GRANT CLARK
PORTLAND, OR
NPI
1104396589
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: OR 275015)
Enumeration Date
2018-11-28
Last Update Date
2018-11-28
Business Address
Ms. REBECCA-KELLY GRANT CLARK OTR/L
3101 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3095
Phone number: 503-221-3429
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Mailing Address
Ms. REBECCA-KELLY GRANT CLARK OTR/L
3101 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3095
Phone number: 503-221-3429
Copy
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