Healthcare Provider Details

I. General information

NPI: 1780609016
Provider Name (Legal Business Name): STEVEN HILLYER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S GARDEN WAY STE 101
EUGENE OR
97401-8034
US

IV. Provider business mailing address

360 S GARDEN WAY STE 101
EUGENE OR
97401-8034
US

V. Phone/Fax

Practice location:
  • Phone: 541-864-9451
  • Fax: 541-868-0484
Mailing address:
  • Phone: 541-864-9451
  • Fax: 541-868-0484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA 00765
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA 00765
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: