Healthcare Provider Details

I. General information

NPI: 1083962435
Provider Name (Legal Business Name): JAMES DENTON WARD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 ST ANTHONY WAY STE 205
PENDLETON OR
97801
US

IV. Provider business mailing address

2801 ST ANTHONY WAY
PENDLETON OR
97801-3800
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-0535
  • Fax: 541-278-4584
Mailing address:
  • Phone: 541-966-0535
  • Fax: 541-278-4584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101020159
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: