Provider Demographics
NPI:1992869325
Name:GARRETT, HILARY E (MS PT)
Entity type:Individual
Prefix:MS
First Name:HILARY
Middle Name:E
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MS
Other - First Name:HILARY
Other - Middle Name:ORT
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2275 NE DOCTORS DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6324
Mailing Address - Country:US
Mailing Address - Phone:541-382-5500
Mailing Address - Fax:541-389-5669
Practice Address - Street 1:2275 NE DOCTORS DR
Practice Address - Street 2:SUITE 3
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6324
Practice Address - Country:US
Practice Address - Phone:541-382-5500
Practice Address - Fax:541-389-5669
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2528225100000X
CA11072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR092689000OtherREGENCE BC BS
OR274012Medicaid
OR50090OtherCLEAR CHOICE AND COIHS
ORP00119244Medicare ID - Type UnspecifiedRAILROAD MEDICARE
OR092689000OtherREGENCE BC BS
OR274012Medicaid