Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4559 | OR |
Y | 213EG0000X | General Practice | 4559 | OR |
NPI | 1003951534 |
---|---|
Provider Name | Stephen Snyder |
First Address | Hood River, OR 97031-1657 |
Second Address | Hood River, OR 97031-1657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |