Provider Demographics
NPI:1114393188
Name:TADAKI, CHIE (DPT)
Entity Type:Individual
Prefix:
First Name:CHIE
Middle Name:
Last Name:TADAKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2709
Mailing Address - Country:US
Mailing Address - Phone:541-484-0693
Mailing Address - Fax:541-343-6206
Practice Address - Street 1:313 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2709
Practice Address - Country:US
Practice Address - Phone:541-484-0693
Practice Address - Fax:541-343-6206
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist