Individual
MICHAEL LOWRIE PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
849 PACIFIC AVE, HOOD RIVER, OR 97031-1956
(541) 308-8370
(541) 308-0754
Mailing address
1040 WEBBER ST, THE DALLES, OR 97058-3749
(541) 298-4160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22825
KY
207Q00000X
Family Medicine Physician
MD14783
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080028716
RAILROAD MEDICARE
—
01
—
11002
BLUE CROSS BLUE SHIELD
—
01
—
1256028
UNITED HEALTHCARE
—
01
—
136170
DEPT OF LABOR AND INDUSTR
WA
05
—
174995
—
OR
05
—
8105546
—
WA
01
—
K066920
MEDICARE -NORTON IMMEDIATE CARE CENTER
KY
01
—
K5099 02
PACIFIC SOURCE
—
Enumeration date
12/13/2005
Last updated
12/22/2017
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