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General NPI Number Information
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NPI Number | 1285765883
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Entity Type | Organization
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Legal Business Name | PENDLETON FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 1600 SE COURT PL STE 201
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City | PENDLETON
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State | OR
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Zip | 97801-3281
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Country | US
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Telephone | 541-276-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 SE COURT PL STE 201
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City | PENDLETON
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State | OR
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Zip | 97801
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Country | US
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Telephone | 541-276-1700
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Fax | 541-276-6327
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BETHEL E HART
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Credential |
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Telephone | 541-276-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OR
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