Provider Demographics
NPI:1003041260
Name:EASTMAN, HANNAH G (PTA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:G
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:G
Other - Last Name:DONALDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:316 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1433
Mailing Address - Country:US
Mailing Address - Phone:920-217-1582
Mailing Address - Fax:
Practice Address - Street 1:316 MILL ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1433
Practice Address - Country:US
Practice Address - Phone:920-217-1582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant