| Gutierrez Holistic Family Medicine Llc | |
|
3575 Donald St Suite 110 Eugene OR 97405-4753 | |
| (458) 205-5907 | |
| (154) 131-9722 |
| Full Name | Gutierrez Holistic Family Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3575 Donald St, Eugene, Oregon |
| Authorized Official Name and Position | Orestes Gutierrez (FAMILY PHYSICIAN) |
| Authorized Official Contact | 5412325627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gutierrez Holistic Family Medicine Llc 3575 Donald St Suite 110 A & B Eugene OR 97405-4753 Ph: (458) 205-5907 | Gutierrez Holistic Family Medicine Llc 3575 Donald St Suite 110 Eugene OR 97405-4753 Ph: (458) 205-5907 |
| NPI Number | 1255693313 |
|---|---|
| Provider Enumeration Date | 06/13/2012 |
| Last Update Date | 12/10/2014 |
| Medicare PECOS PAC ID | 8628227873 |
|---|---|
| Medicare Enrollment ID | O20121003000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255693313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | DO152080 (Oregon) | Primary |
| Provider Name | Anne Marie Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598841660 PECOS PAC ID: 6002965753 Enrollment ID: I20090528000581 |
| Provider Name | Orestes Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558332791 PECOS PAC ID: 4587859269 Enrollment ID: I20101108000571 |
| Provider Name | Wendy Renee Hounsel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376009282 PECOS PAC ID: 1355676230 Enrollment ID: I20190715002522 |
| Provider Name | Cierra B Hibbs Porter Rogge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033762901 PECOS PAC ID: 4981935988 Enrollment ID: I20191004002316 |
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