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1105 Se Jetty Ave Suite C Lincoln City OR 97367-2632 | |
(503) 965-6555 | |
(503) 965-6800 |
Full Name | |
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Speciality | Family Medicine |
Location | 1105 Se Jetty Ave, Lincoln City, Oregon |
Authorized Official Name and Position | Sydney Thompson (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 5039656555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 655 Pacific City OR 97135-0655 Ph: (503) 965-6555 | 1105 Se Jetty Ave Suite C Lincoln City OR 97367-2632 Ph: (503) 965-6555 |
NPI Number | 1871819573 |
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Provider Enumeration Date | 04/20/2010 |
Last Update Date | 04/20/2010 |
Identifier | Type | State | Issuer |
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1871819573 | NPI | - | NPPES |
129788 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | MD13058 (Oregon) | Primary |
Samaritan North Lincoln Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Ne 28th St, Lincoln City, OR 97367 Phone: 541-768-7900 | |