Healthcare Provider Details

I. General information

NPI: 1285954511
Provider Name (Legal Business Name): DRURY HOLLIWAY HALL MN, ARNP, ACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NE NEFF RD STE 200
BEND OR
97701-4281
US

IV. Provider business mailing address

325 9TH AVE REGIONAL EPILEPSY CENTER AT HARBORVIEW
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-3344
  • Fax: 541-382-1681
Mailing address:
  • Phone: 206-744-3576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201401216NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP60154853
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: