| Independence-monmouth Family Medicine Pc | |
|
1430 Monmouth St Independence OR 97351 | |
| (503) 838-1133 | |
| (503) 838-5138 |
| Full Name | Independence-monmouth Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1430 Monmouth St, Independence, Oregon |
| Authorized Official Name and Position | Keith Allen White (OFFICIAL REPRESENTATIVE) |
| Authorized Official Contact | 5038381133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence-monmouth Family Medicine Pc Po Box 309 Independence OR 97351 Ph: (503) 838-1133 | Independence-monmouth Family Medicine Pc 1430 Monmouth St Independence OR 97351 Ph: (503) 838-1133 |
| NPI Number | 1598868515 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598868515 | NPI | - | NPPES |
| 269340 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Wvp Independence Monmouth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1430 Monmouth St, Independence, OR 97351 Phone: 503-838-1133 Fax: 503-838-5138 |