| Doctor Name: | MARIE LONG |
| NPI Number: | 1548312655 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSPT |
| License Number: | 4429 |
| Business Practice Address: | 11910 Sw Greenburg Rd Tigard, OR - 972236453 |
| Business Phone Number: | 5035971151 |
| Business Fax Number: | |
| Mailing Address: | 3824 Ne 112th Ave, PORTLAND |
| State: | OR |
| Postal Code: | 972202407 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4429 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |