Healthcare Provider Details

I. General information

NPI: 1316210248
Provider Name (Legal Business Name): 3-D HEALTHCARE SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 SE 1ST STREET
PENDLETON OR
97801
US

IV. Provider business mailing address

54251 HY 332
MILTON-FREEWATER OR
97862
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-2222
  • Fax: 541-276-8405
Mailing address:
  • Phone: 541-938-3649
  • Fax: 541-938-3760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number31-001194N6
License Number StateOR

VIII. Authorized Official

Name: MR. DANIEL EDWARD ESLINGER
Title or Position: PRESIDENT
Credential:
Phone: 541-938-3649