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NPI Code Detail

MEDICARE: MS. SHERYLL LYNN ROSARIO P.T.

MEDICARE: MS. SHERYLL LYNN ROSARIO P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist3715OR

General Provider Information

NPI Number : 1811192131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHERYLL LYNN ROSARIO P.T.
Provider Business Mailing Address
First Line : PO BOX 5571
Second Line :
City : PORTLAND
State : OR
Zip : 97228-5571
Country : US
Telephone Number : 503-797-9585
Fax Number : 503-797-0650
Provider Business Practice Location Address
First Line : ONE CENTER COURT STE110
Second Line :
City : PORTLAND
State : OR
Zip : 97227-2104
Country : US
Telephone Number : 503-797-9585
Fax Number : 503-797-0650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 07/08/2007

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