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Organization
EMERALD WELLNESS, P.C.
Active
Organization
EMERALD WELLNESS, P.C.
Active
Other names
Emerald Valley Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A. HANSEN M.D. (PRESIDENT)
(541) 895-5300
Entity
Organization
Contact information
Practice address
300 N MILL ST STE A, CRESWELL, OR 97426-9848
(541) 895-5300
Mailing address
PO BOX 1057, CRESWELL, OR 97426-1057
(541) 895-5300
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD22235
OR
Other
Enumeration date
05/22/2007
Last updated
05/02/2012
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