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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