MS. Shana Marlene Basom, PHYSICAL THERAPIST

NPI #1114009479 in Beaverton, Oregon

Provider Information

NPI Number: 1114009479
Entity Type: Individual
Name: MS. Shana Marlene Basom, PHYSICAL THERAPIST
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PHYSICAL THERAPIST
Enumeration Date: Oct 19, 2006
Last Updated: Jul 15, 2009

Practice Location

Address: 735 SW 158TH AVE
Address 2: STE 160
City: Beaverton
State: Oregon
ZIP Code: 97006-4952
Phone: (503) 597-0035

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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