| Canby Healthcare Clinic Llc | |
|
703 Se 1st Ave Canby OR 97013-3849 | |
| (503) 266-7686 | |
| (503) 266-7382 |
| Full Name | Canby Healthcare Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 703 Se 1st Ave, Canby, Oregon |
| Authorized Official Name and Position | Pauline L Richards (OWNER) |
| Authorized Official Contact | 5032667686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canby Healthcare Clinic Llc 703 Se 1st Ave Canby OR 97013-3849 Ph: (503) 266-7686 | Canby Healthcare Clinic Llc 703 Se 1st Ave Canby OR 97013-3849 Ph: (503) 266-7686 |
| NPI Number | 1114253713 |
|---|---|
| Provider Enumeration Date | 11/02/2009 |
| Last Update Date | 02/14/2013 |
| Medicare PECOS PAC ID | 7315074994 |
|---|---|
| Medicare Enrollment ID | O20100430000240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114253713 | NPI | - | NPPES |
| 500618933 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Allyson Claire Munson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912251166 PECOS PAC ID: 2264687243 Enrollment ID: I20141227000123 |
| Provider Name | Susan L Gillette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730742065 PECOS PAC ID: 6406280510 Enrollment ID: I20200108000933 |
| Provider Name | John S Prickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134736838 PECOS PAC ID: 6709206204 Enrollment ID: I20201110000059 |
Health Practitioner Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 143 Nw 4th Ave, Canby, OR 97013 Phone: 503-263-6611 Fax: 503-266-5674 | |
Neighborhood Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 227 Nw 3rd Ave, Canby, OR 97013 Phone: 503-416-4547 Fax: 503-416-4553 | |
Canby Healthcare Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 703 Se 1st Ave, Canby, OR 97013 Phone: 503-266-7686 Fax: 503-266-7382 | |
Providence Medical Group Canby Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 S Hazel Dell Way, Canby, OR 97013 Phone: 503-263-9500 Fax: 503-263-1383 | |
Providence Medical Group Canby Immediate Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 S Hazel Dell Way, Canby, OR 97013 Phone: 503-263-9500 | |
Trent B. Warren, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1507 Se 3rd Ct, Canby, OR 97013 Phone: 503-266-5127 Fax: 503-266-3821 |