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Individual

CHARLES D HYDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
690 N MAIN ST, MOUNT ANGEL, OR 97362-9518
(503) 845-2000
(503) 845-2384
Mailing address
690 N MAIN ST, MOUNT ANGEL, OR 97362-9518
(503) 845-2000
(503) 845-2384

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP576A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010139847
BS CMMC
ID
01
000010139848
BS PLMC
ID
01
000010149870
BS MVMC
ID
05
806538800
ID
01
NPGN2
BC PLMC
ID
01
NPGO0
BC CMMC
ID
01
NPRN0
BC MVMC
ID
Enumeration date
02/09/2007
Last updated
07/06/2009
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