Provider Demographics
NPI:1376363424
Name:HERNANDEZ TRIANA, VICTOR EDUARDO (NREMT, QMHA-R)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:EDUARDO
Last Name:HERNANDEZ TRIANA
Suffix:
Gender:M
Credentials:NREMT, QMHA-R
Other - Prefix:
Other - First Name:VICTOR
Other - Middle Name:
Other - Last Name:TRIANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NREMT, QMHA-R
Mailing Address - Street 1:341 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3275
Mailing Address - Country:US
Mailing Address - Phone:541-342-8255
Mailing Address - Fax:
Practice Address - Street 1:341 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3275
Practice Address - Country:US
Practice Address - Phone:541-342-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24-QMHA-R-5420225400000X
OR206104146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner