Healthcare Provider Details

I. General information

NPI: 1821654625
Provider Name (Legal Business Name): AMY BARRIOS CPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10117 SE SUNNYSIDE RD STE L
CLACKAMAS OR
97015-7708
US

IV. Provider business mailing address

10117 SE SUNNYSIDE RD STE L
CLACKAMAS OR
97015-7708
US

V. Phone/Fax

Practice location:
  • Phone: 503-653-9772
  • Fax: 503-786-2179
Mailing address:
  • Phone: 503-653-9772
  • Fax: 503-786-2179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: