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General NPI Number Information
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NPI Number | 1609265123
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Entity Type | Organization
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Legal Business Name | ALBANY GENERAL HOSPITAL
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 534 PLEASANT VIEW WAY NW, SUITE 200
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City | ALBANY
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State | OR
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Zip | 97321-1700
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Country | US
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Telephone | 541-812-5760
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Fax | 541-812-5650
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Provider Business Mailing Address
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Address Line | 534 PLEASANT VIEW WAY NW, SUITE 200
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City | ALBANY
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State | OR
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Zip | 97321-1700
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Country | US
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Telephone | 541-812-5760
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID G. TRIEBES
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Credential | MBA
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Telephone | 541-812-4102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 14-1459
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License Number State | OR
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