Stacey Leann Abosamra, PT, DPT
Physical Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1063256071
StatusActive
Last updated in NPPESJun 24, 2024
Details
- NPI
- 1063256071
- Entity type
- Individual (NPI-1)
- Name
- Stacey Leann Abosamra
- Credential
- PT, DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 24, 2024
- Certification date
- Jun 24, 2024
- Last updated
- Jun 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 65347 | OR | Yes |
Practice location
2330 Nw Flanders St Ste G1Portland, OR 97210-3441
Phone 503-223-1856
Mailing address
2330 Nw Flanders St Ste G1Portland, OR 97210-3441
Phone 503-223-1856
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