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NPI Code Detail

MEDICARE: OLE HANSEN M.D.

MEDICARE:   OLE  HANSEN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0505XAdult Medicine PhysicianMD11961OR

General Provider Information

NPI Number : 1538495734
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLE HANSEN M.D.
Provider Business Mailing Address
First Line : 2605 STATE ST
Second Line :
City : SALEM
State : OR
Zip : 97310-1346
Country : US
Telephone Number : 503-373-1840
Fax Number : 503-378-2378
Provider Business Practice Location Address
First Line : 2605 STATE ST
Second Line :
City : SALEM
State : OR
Zip : 97310-1346
Country : US
Telephone Number : 503-373-1840
Fax Number : 503-378-2378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2009
Last Update Date : 10/21/2010

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Directions to “ OLE HANSEN M.D.” Practice Location

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