Provider Demographics
NPI:1811057862
Name:HILLSTROM, ROBERT J (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:HILLSTROM
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 1:20545 S MONPANO OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-7343
Mailing Address - Country:US
Mailing Address - Phone:503-342-2575
Mailing Address - Fax:
Practice Address - Street 1:525 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2834
Practice Address - Country:US
Practice Address - Phone:503-623-8301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO29090207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine