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600 Nw 11th St Suite E 15 Hermiston OR 97838 | |
| (541) 567-6434 | |
| (541) 567-6019 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 600 Nw 11th St, Hermiston, Oregon |
| Authorized Official Name and Position | Derek Ted Earl (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5415676434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
600 Nw 11th Street Suite E 15 Hermiston OR 97838 Ph: (541) 567-6434 | 600 Nw 11th St Suite E 15 Hermiston OR 97838 Ph: (541) 567-6434 |
| NPI Number | 1467403329 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 01/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467403329 | NPI | - | NPPES |
| 083709 | Medicaid | OR | |
| 194175200 | Other | W C |
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