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General NPI Number Information
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NPI Number | 1104292358
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Entity Type | Organization
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Legal Business Name | THE OREGON HEMORRHOID CLINIC
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 14000 SE JOHNSON RD STE 110
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City | MILWAUKIE
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State | OR
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Zip | 97267-2316
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Country | US
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Telephone | 503-786-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 14000 SE JOHNSON RD STE 110
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City | MILWAUKIE
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State | OR
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Zip | 97267-2316
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Country | US
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Telephone | 503-786-7272
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRETT J HUBBARD
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Credential | N.D.
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Telephone | 503-786-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 1275673949
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License Number State | OR
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