MEDICARE: DIANNA L ESHLEMAN M.S.

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
1	207R00000X	Internal Medicine Physician	200150092NP	OR
2	207V00000X	Obstetrics & Gynecology Physician	200150110NP	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1396830873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNA L ESHLEMAN M.S.

Provider Business Mailing Address
First Line	:	PO BOX 1036
Second Line	:	MALL 101 , SUITE A
City	:	DEPOE BAY
State	:	OR
Zip	:	97341
Country	:	US
Telephone Number	:	541-765-3265
Fax Number	:	541-765-3260

Provider Business Practice Location Address
First Line	:	MALL 101 SUITE A
Second Line	:
City	:	DEPOE BAY
State	:	OR
Zip	:	97341
Country	:	US
Telephone Number	:	541-765-3265
Fax Number	:	541-768-3260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	04/08/2013

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