Provider Demographics
NPI:1447911359
Name:HUNT, TORY DOROTHY (PA-C)
Entity type:Individual
Prefix:MS
First Name:TORY
Middle Name:DOROTHY
Last Name:HUNT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:TORY
Other - Middle Name:HUNT
Other - Last Name:SPENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:125 S CENTRAL AVE
Mailing Address - Street 2:#201
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7222
Mailing Address - Country:US
Mailing Address - Phone:541-344-9411
Mailing Address - Fax:
Practice Address - Street 1:125 S CENTRAL AVE
Practice Address - Street 2:#201
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501
Practice Address - Country:US
Practice Address - Phone:541-344-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA217898363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherOTHER