| Dr Shawn R Hathaway, MD | |
|
777 Nw 9th St, Suite 320, Corvallis, OR 97330-6169 | |
| (541) 768-4900 | |
| Not Available |
| Full Name | Dr Shawn R Hathaway |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 777 Nw 9th St, Corvallis, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609818202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MD23849 (Oregon) | Primary |
| Entity Name | Good Samaritan Hospital Corvallis |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962453134 PECOS PAC ID: 1557270725 Enrollment ID: O20031125000163 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shawn R Hathaway, MD Po Box 1189, Corvallis, OR 97339-1189 Ph: () - | Dr Shawn R Hathaway, MD 777 Nw 9th St, Suite 320, Corvallis, OR 97330-6169 Ph: (541) 768-4900 |
Dr. Destiny Jennifer Gmelch, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3600 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-768-5111 | |
Chinh T. Le, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 530 Nw 27th St, Corvallis, OR 97330 Phone: 541-766-6835 | |
Elizabeth Ranae Davis, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 3680 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-754-1150 | |
Wayne Joseph Merback, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3600 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-768-5111 | |
Dr. Lon Mcquillan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 777 Nw 9th St, Suite 320, Corvallis, OR 97330 Phone: 541-768-4900 | |
Ms. Kathryn I Mcquillan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3680 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-754-1150 | |
Jill A Miller, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3680 Nw Samaritan Dr, Corvallis, OR 97330 Phone: 541-754-1150 |