Provider Demographics
NPI:1972223204
Name:GEORGE, HANNAH JO (DPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:JO
Last Name:GEORGE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1473 SW CANYON DR
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2935
Mailing Address - Country:US
Mailing Address - Phone:541-408-2084
Mailing Address - Fax:
Practice Address - Street 1:2753 NW LOLO DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7288
Practice Address - Country:US
Practice Address - Phone:541-728-3412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist