Provider Demographics
NPI:1174334056
Name:BARRO, LOURDES BARRO
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:BARRO
Last Name:BARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18481 S LAURA LN
Mailing Address - Street 2:
Mailing Address - City:MULINO
Mailing Address - State:OR
Mailing Address - Zip Code:97042-9700
Mailing Address - Country:US
Mailing Address - Phone:503-975-4693
Mailing Address - Fax:
Practice Address - Street 1:221 MOLALLA AVE STE 120
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-3072
Practice Address - Country:US
Practice Address - Phone:360-504-0122
Practice Address - Fax:360-859-1354
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist