| Organization Name: | THE FAMILY HEALTH CLINIC OF LAPINE |
| NPI Number: | 1013030444 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENDA J MOLINA (PRESIDENT) |
| Mailing Address: | 16480 William Foss Rd La Pine |
| State: | OR US |
| Postal Code: | 977399486 |
| Phone Number: | 5415368012 |
| Fax Number: | 5415369873 |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 10/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |