Provider Demographics
NPI:1437127644
Name:HENDIN, A PERRY (MD)
Entity Type:Individual
Prefix:
First Name:A
Middle Name:PERRY
Last Name:HENDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8329 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-2215
Mailing Address - Country:US
Mailing Address - Phone:503-414-5160
Mailing Address - Fax:503-414-5190
Practice Address - Street 1:8329 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2215
Practice Address - Country:US
Practice Address - Phone:503-414-5160
Practice Address - Fax:503-414-5190
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR044821Medicaid
OROOWFBDCDMedicare ID - Type Unspecified
OR044821Medicaid