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1962141085
JOHN MATTHEW TAN MODINA
PORTLAND, OR
NPI
1962141085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: OR 64474)
Enumeration Date
2022-05-27
Last Update Date
2022-05-27
Business Address
JOHN MATTHEW TAN MODINA PT
332 NE SAN RAFAEL ST
PORTLAND, OR 97212-3948
Phone number: 503-288-2615
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Mailing Address
JOHN MATTHEW TAN MODINA PT
10804 NE 44TH ST
VANCOUVER, WA 98682-6610
Phone number: 360-949-8491
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