Provider Demographics
NPI:1972719516
Name:ONSRUD, MARIJKE (PTOCS)
Entity type:Individual
Prefix:MRS
First Name:MARIJKE
Middle Name:
Last Name:ONSRUD
Suffix:
Gender:F
Credentials:PTOCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25117 SW PARKWAY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1525 E OVATION PL
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780
Practice Address - Country:US
Practice Address - Phone:435-429-0000
Practice Address - Fax:866-728-9636
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8660083-24012251G0304X, 2251X0800X
IDPT 11552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics