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Individual

DANIEL E HENDRICKS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2314 NW KINGS BLVD STE A, CORVALLIS, OR 97330-3925
(541) 758-5047
(541) 758-3713
Mailing address
PO BOX 1418, CORVALLIS, OR 97339-1418
(541) 758-5047
(541) 758-3713

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
0101237463
VA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD29258
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500606405
OR
Enumeration date
05/21/2007
Last updated
01/28/2021
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