Provider Demographics
NPI:1043231954
Name:LUBARSKY, DIANA KAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:KAY
Last Name:LUBARSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 SE TAMORA AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4781
Mailing Address - Country:US
Mailing Address - Phone:503-693-1383
Mailing Address - Fax:503-693-1382
Practice Address - Street 1:2333 PACIFIC AVENUE
Practice Address - Street 2:TUALITY HEALTHCARE FOREST GROVE SHOPPING CENTER
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116
Practice Address - Country:US
Practice Address - Phone:503-359-6145
Practice Address - Fax:503-359-6919
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist