Most Relevant Information
Provider Data
| NPI Number: | 1003005414 |
| Provider Name: | JOAN LUNA VICENTE PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 33804 |
Most Important Dates
| Enumeration Date: | 10/22/2007 |
| Last Updated: | 10/22/2007 |
Provider Practice Location
4560 SE INTERNATIONAL WAY
CONSONUS HEALTHCARE SERVICES SUITE 100
MILWAUKIE
OR
97222
Practice Location Phone/Fax
| Phone: | 9712065149 |
| Fax: | 9712065209 |
Provider Mailing Location
4560 SE INTERNATIONAL WAY
CONSONUS HEALTHCARE SERVICES SUITE 100
MILWAUKIE
OR
97222
Provider Mailing Phone/Fax
| Phone: | 9712065149 |
| Fax: | 9712065209 |