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General NPI Number Information
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NPI Number | 1982850483
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Entity Type | Individual
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Provider Name | JON MICHAEL HARTINGER DO
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Gender | Male
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 3101 SE 192ND AVE SUITE 106
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City | VANCOUVER
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State | WA
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Zip | 98683-1442
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Country | US
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Telephone | 360-553-7400
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Fax | 503-553-7450
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Provider Business Mailing Address
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Address Line | PO BOX 3158
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City | PORTLAND
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State | OR
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Zip | 97208-3158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DO155128
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP60469602
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License Number State | WA
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