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355 W 3rd Ave Junction City OR 97448-1313 | |
(458) 215-2189 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 355 W 3rd Ave, Junction City, Oregon |
Authorized Official Name and Position | Erica Hauser (CFO) |
Authorized Official Contact | 3125905372 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 4858 Portland OR 97208-4858 Ph: () - | 355 W 3rd Ave Junction City OR 97448-1313 Ph: (458) 215-2189 |
NPI Number | 1649886441 |
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Provider Enumeration Date | 09/17/2020 |
Last Update Date | 06/29/2022 |
Medicare PECOS PAC ID | 1355406729 |
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Medicare Enrollment ID | O20201110002678 |
Identifier | Type | State | Issuer |
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1649886441 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |