Provider Demographics
NPI:1205045887
Name:MAIER, DEBORAH J (PT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:MAIER
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 1:2695 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-4009
Mailing Address - Country:US
Mailing Address - Phone:503-297-7639
Mailing Address - Fax:
Practice Address - Street 1:8375 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2252
Practice Address - Country:US
Practice Address - Phone:503-292-5324
Practice Address - Fax:503-292-5577
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist