Basic Information
Provider Information
NPI: 1598117194
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUMYAHN
FirstName: LUKE
MiddleName: HANS
NamePrefix: DR.
NameSuffix:  
Credential: DPT, PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4236828840
FaxNumber: 4236022028
Practice Location
Address1: 914 NW 13TH AVE
Address2:  
City: PORTLAND
State: OR
PostalCode: 972093039
CountryCode: US
TelephoneNumber: 9712449000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/07/2016
LastUpdateDate: 10/18/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X61708ORY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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