Provider Demographics
NPI:1386888154
Name:ESTRELLANES, DINAH ESTRAZA (PT)
Entity type:Individual
Prefix:
First Name:DINAH
Middle Name:ESTRAZA
Last Name:ESTRELLANES
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 1:152 SE 8TH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:MILTON FREEWATER
Mailing Address - State:OR
Mailing Address - Zip Code:97862-1166
Mailing Address - Country:US
Mailing Address - Phone:503-422-8881
Mailing Address - Fax:
Practice Address - Street 1:120 ELZORA ST
Practice Address - Street 2:
Practice Address - City:MILTON FREEWATER
Practice Address - State:OR
Practice Address - Zip Code:97862-9454
Practice Address - Country:US
Practice Address - Phone:541-938-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24505225100000X
OR5806225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist