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400 N Santiam Hwy Lebanon OR 97355 | |
(541) 451-6413 | |
(541) 812-2041 |
Full Name | |
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Speciality | Family Medicine - Geriatric Medicine |
Location | 400 N Santiam Hwy, Lebanon, Oregon |
Authorized Official Name and Position | Wendie Wunderwald (CEO) |
Authorized Official Contact | 5414517195 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Mullins Dr Ste C2 Lebanon OR 97355-2868 Ph: (541) 451-6413 | 400 N Santiam Hwy Lebanon OR 97355 Ph: (541) 451-6413 |
NPI Number | 1043838519 |
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Provider Enumeration Date | 07/10/2020 |
Last Update Date | 07/29/2024 |
Identifier | Type | State | Issuer |
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1043838519 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |