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1205400702
JACK ANDERSON
BEAVERTON, OR
NPI
1205400702
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 64087)
Additional Taxonomies
225100000X Physical Therapist
Enumeration Date
2021-05-18
Last Update Date
2025-03-06
Business Address
JACK ANDERSON DPT
5465 SW WESTERN AVE STE H
BEAVERTON, OR 97005-4179
Phone number: 503-610-9281
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Mailing Address
JACK ANDERSON DPT
5465 SW WESTERN AVE STE H
BEAVERTON, OR 97005-4179
Phone number: 503-610-9281
Copy
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