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525 N Santiam Hwy Lebanon OR 97355-4363 | |
(541) 451-6313 | |
(541) 451-6304 |
Full Name | |
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Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
Location | 525 N Santiam Hwy, Lebanon, Oregon |
Authorized Official Name and Position | Becky A. Pape (CEO) |
Authorized Official Contact | 5417685009 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1193 Corvallis OR 97339-1193 Ph: (541) 258-2101 | 525 N Santiam Hwy Lebanon OR 97355-4363 Ph: (541) 451-6313 |
NPI Number | 1518347608 |
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Provider Enumeration Date | 06/03/2015 |
Last Update Date | 07/29/2015 |
Identifier | Type | State | Issuer |
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1518347608 | NPI | - | NPPES |
500688716 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 14-1453 (Oregon) | Primary |