Healthcare Provider Details

I. General information

NPI: 1528231636
Provider Name (Legal Business Name): HANNAH M FINE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 HARLOW RD STE 310
SPRINGFIELD OR
97477-7127
US

IV. Provider business mailing address

PO BOX 1648
EUGENE OR
97440-1648
US

V. Phone/Fax

Practice location:
  • Phone: 541-463-2280
  • Fax:
Mailing address:
  • Phone: 541-687-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDO164332
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: