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1800 Ne Sturdevant Rd Toledo OR 97391-2413 | |
(541) 265-0445 | |
(541) 265-4993 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1800 Ne Sturdevant Rd, Toledo, Oregon |
Authorized Official Name and Position | Lesa Wagner (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5412650445 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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36 Sw Nye St Newport OR 97365-3821 Ph: (541) 265-0445 | 1800 Ne Sturdevant Rd Toledo OR 97391-2413 Ph: (541) 265-0445 |
NPI Number | 1851626360 |
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Provider Enumeration Date | 10/16/2009 |
Last Update Date | 04/07/2023 |
Identifier | Type | State | Issuer |
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1851626360 | NPI | - | NPPES |
213144 | Medicaid | OR |