Individual
STEPHANIE JUELLE HARTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9370 SW GREENBURG RD STE B, TIGARD, OR 97223-5408
(503) 295-2585
Mailing address
17566 SW YEAGER LN, BEAVERTON, OR 97078-1891
(408) 859-1465
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62321
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500726708
—
OR
01
—
R195135
MEDICARE
OR
Enumeration date
06/18/2017
Last updated
07/09/2020
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