PEOPLES COMMUNITY CLINIC OF NEWBERG LLC NPI 1215486626

NPI Information

NPI: 1215486626
Provider Name: PEOPLES COMMUNITY CLINIC OF NEWBERG LLC

Doing Business As: PEOPLE'S COMMUNITY CLINIC OF NEWBERG

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
1014 N SPRINGBROOK RD STE B
NEWBERG, OR
ZIP 97132
Phone: (503) 449-8988
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PEOPLES COMMUNITY CLINIC OF NEWBERG LLC is a family nurse practitioner in Newberg, OR. PEOPLES COMMUNITY CLINIC OF NEWBERG LLC NPI is 1215486626. The provider is registered as an organization entity type.
The provider Is Doing Business As People's Community Clinic Of Newberg.

The provider's business location address is:

1014 N SPRINGBROOK RD STE B
NEWBERG, OR
ZIP 97132-061
Phone: (503) 449-8988
Fax: (503) 894-9194

The provider's authorized official is Jacqueline Arielle Smith .
The authorized official title is Owner and has the following contact phone number (503) 449-8988.

The CLIA number assigned to this NPI record is 38D2129446 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2016 and was last updated on 8/18/2021.

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
1	261QP2300X	Clinic/Center	Primary Care			No
2	363LF0000X	Nurse Practitioner	Family	201350039NP	OREGON	Yes

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
1	500720379	MEDICAID	OREGON

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

NPI Synchronization or Removal

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