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NPI Code Detail

MEDICARE: GRETEL ELIZABETH HONIS MD

MEDICARE: GRETEL ELIZABETH HONIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMD26698OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1025349029OTHERORBSOR
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194760884
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETEL ELIZABETH HONIS MD
Provider Business Mailing Address
First Line : 525 SE WASHINGTON ST
Second Line :
City : DALLAS
State : OR
Zip : 97338-2834
Country : US
Telephone Number : 503-623-8301
Fax Number :
Provider Business Practice Location Address
First Line : 525 SE WASHINGTON ST
Second Line :
City : DALLAS
State : OR
Zip : 97338-2834
Country : US
Telephone Number : 503-623-8301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 01/23/2013

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