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1801463831
MARK KEVIN GUMTANG
PORTLAND, OR
NPI
1801463831
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 64108)
Enumeration Date
2021-06-08
Last Update Date
2021-06-08
Business Address
Dr. MARK KEVIN GUMTANG PT, DPT
2512 SE 109TH AVE
PORTLAND, OR 97266-1215
Phone number: 503-388-3755
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Mailing Address
Dr. MARK KEVIN GUMTANG PT, DPT
7067 SE BLANTON ST APT 5304
HILLSBORO, OR 97123-2701
Phone number: 808-282-1195
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