Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 205 Main St, Aumsville, Oregon |
Authorized Official Name and Position | Lynda Fraser (CLINIC DIRECTOR) |
Authorized Official Contact | 5037699254 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 139 Aumsville OR 97325-0139 Ph: (503) 749-4734 | 205 Main St Aumsville OR 97325 Ph: (503) 749-4734 |
NPI Number | 1558404103 |
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Provider Enumeration Date | 02/14/2007 |
Last Update Date | 09/28/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558404103 | NPI | - | NPPES |
287224 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |