Provider Demographics
NPI:1578276762
Name:GUINN, VICTORIA ELIZABETH (DPT, PT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ELIZABETH
Last Name:GUINN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 SW GREENBURG RD
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6453
Mailing Address - Country:US
Mailing Address - Phone:503-620-5556
Mailing Address - Fax:
Practice Address - Street 1:16621 CHAMPION WAY STE 100
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-7258
Practice Address - Country:US
Practice Address - Phone:503-668-5321
Practice Address - Fax:503-668-9742
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist