Provider Demographics
NPI:1760184881
Name:HINTON, JEREMY THOMAS (DO)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:THOMAS
Last Name:HINTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 SW CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1063
Mailing Address - Country:US
Mailing Address - Phone:503-349-8411
Mailing Address - Fax:
Practice Address - Street 1:LEGACY GOOD SAMARITAN MEDICAL CENTER- GME
Practice Address - Street 2:1015 NW 22ND AVE
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210
Practice Address - Country:US
Practice Address - Phone:503-413-8401
Practice Address - Fax:503-413-7361
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program