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NPI Code Detail

MEDICARE: HOOD RIVER MEDICAL GROUP, PC

MEDICARE: HOOD RIVER MEDICAL GROUP, PC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1346452133
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOOD RIVER MEDICAL GROUP, PC
Provider Business Mailing Address
First Line : 1304 MONTELLO AVE
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1544
Country : US
Telephone Number : 541-386-3711
Fax Number : 541-386-6224
Provider Business Practice Location Address
First Line : 1304 MONTELLO AVE
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1544
Country : US
Telephone Number : 541-386-3711
Fax Number : 541-386-6224
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. DIANE K PHILLEY
Credential :
Telephone Number : 541-386-3711
Provider Enumeration Date : 05/04/2007
Last Update Date : 08/22/2020

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Directions to “HOOD RIVER MEDICAL GROUP, PC ” Practice Location

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