1801035928 NPI number — DR. ABIGAIL HEPPNER HODGSON D.C.

Table of content: DR. ABIGAIL HEPPNER HODGSON D.C. (NPI 1801035928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801035928 NPI number — DR. ABIGAIL HEPPNER HODGSON D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HODGSON
Provider First Name:
ABIGAIL
Provider Middle Name:
HEPPNER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HEPPNER HODGSON
Provider Other First Name:
ABBY
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1801035928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1010 13TH ST SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97302-2507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-391-9222
Provider Business Mailing Address Fax Number:
503-363-8193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 13TH ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97302-2507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-391-9222
Provider Business Practice Location Address Fax Number:
503-363-8193
Provider Enumeration Date:
02/12/2009

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: 111N00000X , with the licence number:  3905 , 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)





Copyright © 2007-2025 www.npivalidator.com