Provider Demographics
NPI:1548492143
Name:HOELTER, TARAH SUE (DPT)
Entity type:Individual
Prefix:
First Name:TARAH
Middle Name:SUE
Last Name:HOELTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TARAH
Other - Middle Name:SUE
Other - Last Name:MCALLISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5212 SE 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206
Mailing Address - Country:US
Mailing Address - Phone:503-777-1983
Mailing Address - Fax:503-771-1984
Practice Address - Street 1:5212 SE 52ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206
Practice Address - Country:US
Practice Address - Phone:503-777-1983
Practice Address - Fax:503-771-1984
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist