Healthcare Provider Details

I. General information

NPI: 1275363855
Provider Name (Legal Business Name): SHARON LEE HODGES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON LEE HEBERT

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARDEN WAY
EUGENE OR
97401-8173
US

IV. Provider business mailing address

3355 RIVERBEND DR STE 300
SPRINGFIELD OR
97477-8800
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone: 541-222-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10057862
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number200842153RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: