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1114009479
SHANA MARLENE BASOM
BEAVERTON, OR
NPI
1114009479
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 5283)
Enumeration Date
2006-10-19
Last Update Date
2009-07-15
Business Address
Ms. SHANA MARLENE BASOM Physical Therapist
735 SW 158TH AVE STE 160
BEAVERTON, OR 97006-4952
Phone number: 503-597-0035
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Mailing Address
Ms. SHANA MARLENE BASOM Physical Therapist
735 SW 158TH AVE STE 160
BEAVERTON, OR 97006-4952
Phone number: 503-597-0035
Copy
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