Provider Demographics
NPI:1033287057
Name:HUNT, PAULA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30646 SMITH LOOP
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-9458
Mailing Address - Country:US
Mailing Address - Phone:541-231-3869
Mailing Address - Fax:
Practice Address - Street 1:30646 SMITH LOOP
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-9458
Practice Address - Country:US
Practice Address - Phone:541-231-3869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3342225100000X
WA7148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR158528OtherOMAP #
OR158528OtherOMAP #