Healthcare Provider Details

I. General information

NPI: 1699009217
Provider Name (Legal Business Name): ERIN ELIZABETH LEGRAND D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ELIZABETH GOOD D.O.

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 NW 5TH ST STE 101
REDMOND OR
97756-1869
US

IV. Provider business mailing address

340 NW 5TH ST STE 101
REDMOND OR
97756-1869
US

V. Phone/Fax

Practice location:
  • Phone: 541-526-6635
  • Fax: 541-526-6636
Mailing address:
  • Phone: 541-526-6635
  • Fax: 541-526-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101018947
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDO171425
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: