DIEDRA M PINE

PORTLAND, OR
NPI1942321104
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225XP0200X Occupational Therapist, Pediatrics
(Licence: OR  01060048)
Enumeration Date2007-04-03
Last Update Date2007-07-08
Business Address
-- DIEDRA M PINE MOT
1675 SW MARLOW AVE STE 200
PORTLAND, OR 97225-5102
Phone number: 503-802-5261
Mailing Address
-- DIEDRA M PINE MOT
4548 NE HOLMAN ST
PORTLAND, OR 97218-1349
Phone number: 503-289-5901