Organization
BRUCE D. CARLSON M.D.
Active
Other names
HERMISTON FAMILY MEDICINE AND URGENT CARE
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI J FOSTER (OFFICE MANAGER)
(541) 567-1137
Entity
Organization
Contact information
Practice address
236 E NEWPORT AVE, HERMISTON, OR 97838-2449
(541) 567-1137
(541) 567-2336
Mailing address
236 E NEWPORT AVE, HERMISTON, OR 97838-2449
(541) 567-1137
(541) 567-2336
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080385000
BLUE CROSS BLUE SHIELD
OR
05
—
223149
—
OR
01
—
OR1807
HEALTH NET OF OREGON
OR
Enumeration date
12/26/2006
Last updated
04/19/2022
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