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280 S First Ave Mill City OR 97360 | |
(503) 897-4100 | |
(503) 897-2673 |
Full Name | |
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Speciality | Family Medicine |
Location | 280 S First Ave, Mill City, Oregon |
Authorized Official Name and Position | Shannon R Waddle (OFFICE MANAGER) |
Authorized Official Contact | 5038974100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 47 Mill City OR 97360-0047 Ph: (503) 897-4100 | 280 S First Ave Mill City OR 97360 Ph: (503) 897-4100 |
NPI Number | 1205048097 |
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Provider Enumeration Date | 05/04/2007 |
Last Update Date | 09/28/2016 |
Identifier | Type | State | Issuer |
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1205048097 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |