Provider Demographics
NPI:1275597676
Name:HUGHES, DANA K (MPT, OCS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:K
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 NW SPRUCE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-2234
Mailing Address - Country:US
Mailing Address - Phone:541-207-3436
Mailing Address - Fax:541-207-2384
Practice Address - Street 1:971 NW SPRUCE AVE STE 101
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-2234
Practice Address - Country:US
Practice Address - Phone:541-207-3436
Practice Address - Fax:541-207-3284
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1695225100000X
NJQA06584225100000X
OR62529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3401326Medicaid