Olive Tree Medical Care, Llc | |
1803 Main St # B Klamath Falls OR 97601-2636 | |
(541) 887-2200 | |
(541) 887-2011 |
Full Name | Olive Tree Medical Care, Llc |
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Speciality | Clinic/Center |
Location | 1803 Main St # B, Klamath Falls, Oregon |
Authorized Official Name and Position | Sara Jeanne Marchessault (OWNER) |
Authorized Official Contact | 5418872200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Olive Tree Medical Care, Llc 1803b Main St Klamath Falls OR 97601-2636 Ph: (541) 887-2200 | Olive Tree Medical Care, Llc 1803 Main St # B Klamath Falls OR 97601-2636 Ph: (541) 887-2200 |
NPI Number | 1366036238 |
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Provider Enumeration Date | 02/22/2021 |
Last Update Date | 02/22/2021 |
Medicare PECOS PAC ID | 3173914199 |
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Medicare Enrollment ID | O20211231000086 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366036238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Sara J Marchessault |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376909770 PECOS PAC ID: 0042516452 Enrollment ID: I20210518001387 |
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