Provider Demographics
NPI:1467345165
Name:DIETER, HUNTER
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:DIETER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21136 NE INTERLACHEN LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97024-8724
Mailing Address - Country:US
Mailing Address - Phone:503-880-5910
Mailing Address - Fax:
Practice Address - Street 1:9427 SW BARNES RD STE 197
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6667
Practice Address - Country:US
Practice Address - Phone:503-216-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist