Individual
JONAS H OLTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 NW 11TH ST, SUITE E-15, HERMISTON, OR 97838-8605
(541) 567-6434
(541) 429-6613
Mailing address
600 NW 11TH ST, SUITE E-15, HERMISTON, OR 97838-8605
(541) 567-6434
(541) 429-6613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO166841
OR
207Q00000X
Family Medicine Physician
TL4128
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500672677
—
OR
01
—
R175916
MEDICARE
OR
Enumeration date
07/05/2011
Last updated
11/24/2014
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