Basic Information
| Provider Information | |||||||||
| NPI: | 1730313909 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HILEMAN | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 NW RALEIGH ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972102456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6236878800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2211 NE 139TH ST | ||||||||
| Address2: | LEGACY SALMON CREEK MEDICAL CENTER | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986862742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034138407 | ||||||||
| FaxNumber: | 3604871000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2009 | ||||||||
| LastUpdateDate: | 07/16/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OP 60286013 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.