Provider Demographics
NPI:1366556516
Name:DHILLON, HARPREET KAUR (DO)
Entity type:Individual
Prefix:
First Name:HARPREET
Middle Name:KAUR
Last Name:DHILLON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:H.
Other - Middle Name:DAISY
Other - Last Name:DHILLON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2800 SW 257TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-1803
Mailing Address - Country:US
Mailing Address - Phone:503-667-7711
Mailing Address - Fax:503-669-8328
Practice Address - Street 1:2800 SW 257TH AVE
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-1803
Practice Address - Country:US
Practice Address - Phone:503-667-7711
Practice Address - Fax:503-669-8328
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO20652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080151055OtherRAILROAD MEDICARE
OR134139Medicaid
OR134139Medicaid
104519Medicare ID - Type Unspecified