Organization Name: | WILLAMETTE VALLEY CLINICS LLC |
NPI Number: | 1790740520 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBBIE T. BREWER (DIRECTOR) |
Mailing Address: | 2700 Se Stratus Ave Ste. 302 Mcminnville |
State: | OR US |
Postal Code: | 971286255 |
Phone Number: | 5034742565 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2006 |
NPI Last Update Date: | 12/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |