Individual
NICHOLAS JON HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD-PHD
Contact information
Practice address
890 OAK ST SE, SALEM, OR 97301-3905
(503) 561-5200
Mailing address
890 OAK ST SE, SALEM, OR 97301-3905
(503) 561-5200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD225912
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2021
Last updated
08/06/2025
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