Provider Demographics
NPI:1053542183
Name:MIL, RONALD I (OT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:I
Last Name:MIL
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 NE HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4742
Mailing Address - Country:US
Mailing Address - Phone:971-337-5567
Mailing Address - Fax:971-337-5567
Practice Address - Street 1:6410 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-4742
Practice Address - Country:US
Practice Address - Phone:971-337-5567
Practice Address - Fax:971-337-5567
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1057982225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist