Provider Demographics
NPI:1245254945
Name:HILLSBORO ORTHOPEDIC GROUP, INC.
Entity type:Organization
Organization Name:HILLSBORO ORTHOPEDIC GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:
Authorized Official - Last Name:RASK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-648-0803
Mailing Address - Street 1:349 SE 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4112
Mailing Address - Country:US
Mailing Address - Phone:503-648-0803
Mailing Address - Fax:503-640-4313
Practice Address - Street 1:349 SE 7TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4112
Practice Address - Country:US
Practice Address - Phone:503-648-0803
Practice Address - Fax:503-640-4313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR084772Medicaid
OR0720860001Medicare NSC
ORR0000WCHZSMedicare PIN