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1942321104
DIEDRA M PINE
PORTLAND, OR
NPI
1942321104
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: OR 01060048)
Enumeration Date
2007-04-03
Last Update Date
2007-07-08
Business Address
-- DIEDRA M PINE MOT
1675 SW MARLOW AVE STE 200
PORTLAND, OR 97225-5102
Phone number: 503-802-5261
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Mailing Address
-- DIEDRA M PINE MOT
4548 NE HOLMAN ST
PORTLAND, OR 97218-1349
Phone number: 503-289-5901
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