Provider Demographics
NPI:1952956641
Name:NORRIS, SOLOMON A (ATC)
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:A
Last Name:NORRIS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30195 SW BROWN RD APT 44
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9582
Mailing Address - Country:US
Mailing Address - Phone:503-750-4112
Mailing Address - Fax:
Practice Address - Street 1:30195 SW BROWN RD APT 44
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-9582
Practice Address - Country:US
Practice Address - Phone:503-750-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer