| La Clinica Del Valle Family Health Care Center Inc. | |
|
745 N Rose St Phoenix OR 97535-5704 | |
| (541) 535-6239 | |
| (541) 494-1789 |
| Full Name | La Clinica Del Valle Family Health Care Center Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 745 N Rose St, Phoenix, Oregon |
| Authorized Official Name and Position | Traci Fossen (CHIEF QUALITY OFFICER) |
| Authorized Official Contact | 5415123912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Clinica Del Valle Family Health Care Center Inc. 931 Chevy Way Medford OR 97504-4127 Ph: (541) 535-6239 | La Clinica Del Valle Family Health Care Center Inc. 745 N Rose St Phoenix OR 97535-5704 Ph: (541) 535-6239 |
| NPI Number | 1811621899 |
|---|---|
| Provider Enumeration Date | 07/14/2022 |
| Last Update Date | 07/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811621899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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