Healthcare Provider Details

I. General information

NPI: 1205915691
Provider Name (Legal Business Name): DIRK ANTHONY OHLING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2119 PACIFIC BLVD SW STE 102
ALBANY OR
97321-1475
US

IV. Provider business mailing address

PO BOX 1517
PENDLETON OR
97801-0410
US

V. Phone/Fax

Practice location:
  • Phone: 541-924-2873
  • Fax: 541-844-3732
Mailing address:
  • Phone: 877-708-1119
  • Fax: 541-278-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD21054
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: