| |
1014 N Springbrook Rd Ste B Newberg OR 97132-2061 | |
(503) 449-8988 | |
(503) 894-9194 |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 1014 N Springbrook Rd Ste B, Newberg, Oregon |
Authorized Official Name and Position | Jacqueline Arielle Smith (OWNER) |
Authorized Official Contact | 5034498988 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1014 N Springbrook Rd Ste B Newberg OR 97132-2061 Ph: (503) 449-8988 | 1014 N Springbrook Rd Ste B Newberg OR 97132-2061 Ph: (503) 449-8988 |
NPI Number | 1215486626 |
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Provider Enumeration Date | 09/26/2016 |
Last Update Date | 08/18/2021 |
Medicare PECOS PAC ID | 7517244494 |
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Medicare Enrollment ID | O20170502000732 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215486626 | NPI | - | NPPES |
500720379 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | 201350039NP (Oregon) | Primary |
Provider Name | Sheila M Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053379479 PECOS PAC ID: 3072530534 Enrollment ID: I20130415000499 |
Provider Name | Emily Diane Brodin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932898897 PECOS PAC ID: 5698134914 Enrollment ID: I20230705002587 |
Virginia Garcia Memorial Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2251 E Hancock St Ste 106, Newberg, OR 97132 Phone: 971-281-3050 Fax: 971-281-3051 | |
Matthew Frey, L.ac., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 E 1st St, Newberg, OR 97132 Phone: 503-538-7338 Fax: 503-538-7339 | |
Virginia Garcia Memorial Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2251 E Hancock St, Newberg, OR 97132 Phone: 971-281-3000 Fax: 503-537-0141 |