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General NPI Number Information
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NPI Number | 1467982835
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Entity Type | Individual
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Provider Name | STEPHANIE JUELLE HARTMAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 9370 SW GREENBURG RD STE B
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City | TIGARD
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State | OR
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Zip | 97223-5408
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Country | US
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Telephone | 503-295-2585
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Fax |
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Provider Business Mailing Address
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Address Line | 17566 SW YEAGER LN
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City | BEAVERTON
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State | OR
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Zip | 97078-1891
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Country | US
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Telephone | 408-859-1465
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 62321
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License Number State | OR
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