1134359151 NPI number — DR. CARRIE LEIGH HAMBY ATCHESON MD, MPH

Table of content: DR. CARRIE LEIGH HAMBY ATCHESON MD, MPH (NPI 1134359151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134359151 NPI number — DR. CARRIE LEIGH HAMBY ATCHESON MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATCHESON
Provider First Name:
CARRIE
Provider Middle Name:
LEIGH HAMBY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAMBY
Provider Other First Name:
CARRIE
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134359151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 35147
Provider Second Line Business Mailing Address:
#1801
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98124-5147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-299-9906
Provider Business Mailing Address Fax Number:
503-225-9002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
707 SW WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 700
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97205-3536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-299-9906
Provider Business Practice Location Address Fax Number:
503-225-9002
Provider Enumeration Date:
07/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  MD168252 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 500674686 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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