| Evergreen Family Care | |
|
685 Evergreen Rd Woodburn OR 97071 | |
| (503) 982-2212 | |
| (503) 982-2214 |
| Full Name | Evergreen Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 685 Evergreen Rd, Woodburn, Oregon |
| Authorized Official Name and Position | Patrick Charles Mcdonald (PRESIDENT) |
| Authorized Official Contact | 5039822212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Family Care 685 Evergreen Rd Woodburn OR 97071 Ph: (503) 982-2212 | Evergreen Family Care 685 Evergreen Rd Woodburn OR 97071 Ph: (503) 982-2212 |
| NPI Number | 1235141086 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 09/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235141086 | NPI | - | NPPES |
| 207217 | Medicaid | OR | |
| 067900000 | Other | BC | |
| 110204464 | Other | RR MC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD13817 (Oregon) | Primary |
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