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CANBY HEALTHCARE CLINIC LLC NPI 1114253713


NPI Information

NPI: 1114253713
Provider Name: CANBY HEALTHCARE CLINIC LLC

Former Legal Business Name: CANBY HEALTHCARE CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
703 SE 1ST AVE
CANBY, OR
ZIP 97013
Phone: (503) 266-7686
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CANBY HEALTHCARE CLINIC LLC is a rural health clinic center in Canby, OR. CANBY HEALTHCARE CLINIC LLC NPI is 1114253713. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Canby Healthcare Clinic.

The provider's business location address is:

703 SE 1ST AVE
CANBY, OR
ZIP 97013-849
Phone: (503) 266-7686
Fax: (503) 266-7382

The provider's authorized official is Pauline L Richards .
The authorized official title is Owner and has the following contact phone number (503) 266-7686.

The enumeration date for this NPI number is 11/2/2009 and was last updated on 2/14/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0505XFamily MedicineAdult MedicineNo
2261QR1300XClinic/CenterRural HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1R152669MEDICARE UPINOREGON
2500618933MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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