LISA MICHELLE CALLAHAN NPI 1588739130

NPI Information

NPI: 1588739130
Provider Name: LISA MICHELLE CALLAHAN

Doing Business As: GRANTS PASS PEDIATRICS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 38D1051934

Address:
1601 NE 6TH ST
GRANTS PASS, OR
ZIP 97526
Phone: (541) 476-3636
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LISA MICHELLE CALLAHAN is a primary care clinic center in Grants Pass, OR. LISA MICHELLE CALLAHAN NPI is 1588739130. The provider is registered as an organization entity type.
The provider Is Doing Business As Grants Pass Pediatrics.

The provider's business location address is:

1601 NE 6TH ST
GRANTS PASS, OR
ZIP 97526-035
Phone: (541) 476-3636
Fax: (541) 474-4628

The provider's authorized official is Lisa Michelle Callahan .
The authorized official title is Owner and has the following contact phone number (541) 472-0021.

The CLIA number assigned to this NPI record is 38D1051934 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 10/12/2016.

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	94000382N2	OREGON	Yes

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: 4/28/2024

NPI Synchronization or Removal

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