| Clara A. Bozievich, M.d., Llc | |
|
410 Nw Walnut Blvd Ste C Corvallis OR 97330-3890 | |
| (541) 286-6715 | |
| (541) 286-6716 |
| Full Name | Clara A. Bozievich, M.d., Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 410 Nw Walnut Blvd Ste C, Corvallis, Oregon |
| Authorized Official Name and Position | Clara A Bozievich (OWNER) |
| Authorized Official Contact | 5412866715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clara A. Bozievich, M.d., Llc 922 Nw Circle Blvd Ste 160-299 Corvallis OR 97330-1483 Ph: (541) 286-6715 | Clara A. Bozievich, M.d., Llc 410 Nw Walnut Blvd Ste C Corvallis OR 97330-3890 Ph: (541) 286-6715 |
| NPI Number | 1861091670 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Medicare PECOS PAC ID | 8224448659 |
|---|---|
| Medicare Enrollment ID | O20201113000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861091670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Clara Antoinette Bozievich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326105040 PECOS PAC ID: 5597750315 Enrollment ID: I20040527001364 |
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