| NPI | 1790189025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SASCHA GERVAIS Owner/Physical Therapist 503-453-6335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: OR 4469) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: OR 306415) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |