| Middle Way Health Care Llc | |
|
2615 6th St Tillamook OR 97141-4114 | |
| (503) 812-7367 | |
| Not Available |
| Full Name | Middle Way Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2615 6th St, Tillamook, Oregon |
| Authorized Official Name and Position | Lisa Joy Kendall (BOARD MEMBER/ FNP) |
| Authorized Official Contact | 5308127367 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Way Health Care Llc 2615 6th St Tillamook OR 97141-4114 Ph: (503) 842-4809 | Middle Way Health Care Llc 2615 6th St Tillamook OR 97141-4114 Ph: (503) 812-7367 |
| NPI Number | 1417146549 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 4880774470 |
|---|---|
| Medicare Enrollment ID | O20080109000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417146549 | NPI | - | NPPES |
| 1245291756 | Other | OR | NPI FOR LISA KENDALL FNP |
| 218477 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 094006492N1 (Oregon) | Primary |
| Provider Name | Lisa J Kendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245291756 PECOS PAC ID: 9739279985 Enrollment ID: I20071212000376 |
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