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1376854992
ORION LAMBERT KOOISTRA
PORTLAND, OR
NPI
1376854992
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 6290)
Enumeration Date
2010-06-29
Last Update Date
2021-03-12
Business Address
ORION LAMBERT KOOISTRA DPT
3942 NE 11TH AVE
PORTLAND, OR 97212-1236
Phone number: 503-334-9799
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Mailing Address
ORION LAMBERT KOOISTRA DPT
3942 NE 11TH AVE
PORTLAND, OR 97212-1236
Phone number: 503-334-9799
Copy
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