# HALE2 MEN'S CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HALE MEN'S CLINIC, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730695032
- **Authorized official:** DR. KRISTIAN MARTIN FERRY MD (OWNER)
- **Authorized official phone:** (541) 228-3660

## Contact information

- **Practice address:** 1410 OAK ST STE 101, EUGENE, OR 97401-4668
- **Practice address phone:** (541) 228-3660
- **Practice address fax:** (541) 228-3266
- **Mailing address:** 1410 OAK ST STE 101, EUGENE, OR 97401-4668
- **Mailing address phone:** (541) 228-3660
- **Mailing address fax:** (541) 228-3266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | NP201401588 | OR | — |

## Other

- **Enumeration date:** 12/21/2017
- **Last updated:** 12/21/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 621399 | NAICS CODE | OR |
| 01 | — | 9978 | EFTPS | — |