ANDREA RAE ICENOGLE

BEAVERTON, OR
NPI1982939179
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: OR  241705)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: AZ  4434)
Enumeration Date2009-10-06
Last Update Date2009-10-06
Business Address
-- ANDREA RAE ICENOGLE
663 SW 175TH PL
BEAVERTON, OR 97006-7909
Phone number: 503-997-8954
Mailing Address
-- ANDREA RAE ICENOGLE
663 SW 175TH PL
BEAVERTON, OR 97006-7909
Phone number: 503-997-8954