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General NPI Number Information
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NPI Number | 1467345165
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Entity Type | Individual
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Provider Name | HUNTER DIETER
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Gender | Male
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Dates
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Enumeration Date | 05/31/2025
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 9427 SW BARNES RD STE 197
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City | PORTLAND
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State | OR
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Zip | 97225-6667
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Country | US
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Telephone | 503-216-1250
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Fax |
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Provider Business Mailing Address
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Address Line | 21136 NE INTERLACHEN LN
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City | FAIRVIEW
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State | OR
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Zip | 97024-8724
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Country | US
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Telephone | 503-880-5910
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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