Provider Demographics
NPI:1306078159
Name:HOELTER, JULIA A (DPT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:HOELTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:A
Other - Last Name:SMETANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 NE 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-4896
Mailing Address - Country:US
Mailing Address - Phone:360-882-2778
Mailing Address - Fax:
Practice Address - Street 1:501 SE 172ND AVE # 110
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-9542
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:360-604-1773
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6031225100000X
WA60604173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2055033Medicaid
ORR172177OtherMEDICARE
ORP01683740OtherRR MEDICARE
OR500611057Medicaid
ORR172177OtherMEDICARE
ORR191020Medicare PIN