Provider Demographics
NPI:1750451878
Name:COLIN HOOBLER PC
Entity Type:Organization
Organization Name:COLIN HOOBLER PC
Other - Org Name:DBA: CH PHYSICAL THERAPY & PERSONAL TRAINING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOOBLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:971-244-9000
Mailing Address - Street 1:815 NW 13TH AVE STE C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3022
Mailing Address - Country:US
Mailing Address - Phone:503-546-6392
Mailing Address - Fax:503-546-9150
Practice Address - Street 1:914 NW 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3039
Practice Address - Country:US
Practice Address - Phone:971-244-9000
Practice Address - Fax:971-244-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4996261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR131444Medicare PIN