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General NPI Number Information
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NPI Number | 1346422433
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Entity Type | Individual
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Provider Name | TERESA MARIA HASENOUR MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 14145 SW 105TH AVE
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City | TIGARD
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State | OR
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Zip | 97224-4808
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Country | US
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Telephone | 503-639-1144
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Fax |
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Provider Business Mailing Address
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Address Line | 10932 SW DURHAM RD APT 236
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City | TIGARD
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State | OR
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Zip | 97224-4847
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Country | US
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Telephone | 181-523-8687
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1070523
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License Number State | OR
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