Individual
ANTHONY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 CENTERPOINTE DR STE 600, LAKE OSWEGO, OR 97035-8662
(503) 603-7355
Mailing address
2345 PARK RIDGE LN, EUGENE, OR 97405-1729
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201706721NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201706722DP
OREGON DISPENSING PRIVILEGE
OR
Enumeration date
08/21/2017
Last updated
01/25/2024
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