Paul Hernandez
Individual provider Active NPI Physical Therapist · Fairview, OR
NPI 1295159796 · NPPES record last updated Feb 5, 2014
Key facts
- NPI
- 1295159796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 06477 (OR)
- Practice address
- 1480 NE Village St
Fairview, OR 97024-3827 - Phone
- (503) 489-6250
- Fax
- (503) 489-1650
- NPI assigned
- Feb 5, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 06477 | OR | Yes |
Addresses
Primary practice location
1480 NE Village St
Fairview, OR 97024-3827
Mailing address
3216 SW 11TH Ave Apt B
Portland, OR 97239-3044
Other providers in Fairview, OR
- Montreal Granville
- Asher Grimm
- Michael James Gush
- Nollan Han
- Ashley Rene Hays
- Sharel Highland
- Denise Irene Houck
- Daniel L Hubbell
- Colton Hubler
- Gary Thomas Ives
All providers in Fairview, OR · Physical Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.