Provider Demographics
NPI:1194356311
Name:IWASAKI PFEIFER, AMALIA MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:MARGARET
Last Name:IWASAKI PFEIFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMALIA
Other - Middle Name:MARGARET
Other - Last Name:IWASAKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16083 SW UPPER BOONES FERRY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7736
Mailing Address - Country:US
Mailing Address - Phone:503-443-6156
Mailing Address - Fax:
Practice Address - Street 1:17355 BOONES FERRY RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5225
Practice Address - Country:US
Practice Address - Phone:503-635-0844
Practice Address - Fax:503-635-0812
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist