Active NPI
Tracy E Hulleman, PT
- Physical Therapist
- Beaverton, OR
National Provider Identifier
1356555429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4835
- Practice address
- 12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475 - Phone
- (503) 216-8825
- NPI assigned
- May 9, 2007
- Last updated
- Nov 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4835 | OR | Primary |
Addresses
Primary practice location
12345 SW Horizon Blvd Ste 57
Beaverton, OR 97007-9475
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other practice location 1
5050 NE Hoyt St Ste 156
Portland, OR 97213-2956
Phone (503) 215-6488
Other names 1
- Tracy E Walter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4835 | OR | MD | Physical Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Hillsboro, OR
- NPI 1891397121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1356555429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12345 SW HORIZON BLVD STE 57",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970079475",
"telephone_number": "503-216-8825"
}
],
"practiceLocations": [
{
"address_1": "5050 NE Hoyt St Ste 156",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972132956",
"country_code": "US",
"telephone_number": "503-215-6488",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HULLEMAN",
"first_name": "TRACY",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "4835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "WALTER",
"middle_name": "E",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.