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General NPI Number Information
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NPI Number | 1093998015
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Entity Type | Individual
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Provider Name | ROBIN JEANNE BOUSQUET MPT
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Gender | Female
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 14780 SW OSPREY DR SUITE 270
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City | BEAVERTON
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State | OR
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Zip | 97007-8028
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Country | US
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Telephone | 971-246-7478
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Fax | 971-249-3191
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Provider Business Mailing Address
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Address Line | 14780 SW OSPREY DR SUITE 270
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City | BEAVERTON
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State | OR
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Zip | 97007-8028
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Country | US
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Telephone | 971-246-7478
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Fax | 971-249-3191
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT 22975
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT22975
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 60890
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 60890
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License Number State | OR
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