THE LAKESIDE CLINIC NPI 1710923651

NPI Information

  • NPI: 1710923651
  • Provider Name: THE LAKESIDE CLINIC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Address: 38843 DEXTER RD
    DEXTER, OR
    ZIP 97431
  • Phone: (541) 937-2134

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NPI Details

THE LAKESIDE CLINIC is a rural health clinic center in Dexter, OR. THE LAKESIDE CLINIC NPI is 1710923651. The provider is registered as an organization entity type.

The provider's business location address is:

38843 DEXTER RD
DEXTER, OR
ZIP 97431-775
Phone: (541) 937-2134
Fax: (541) 937-1370

The provider's authorized official is Jayne Culberson .
The authorized official title is Cfo and has the following contact phone number (541) 937-2134.

The enumeration date for this NPI number is 6/21/2006 and was last updated on 12/17/2009.

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
1261QR1300XClinic/CenterRural Health084054259N1OREGONYes

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
1W20367MEDICARE UPINOREGON
2383808MEDICARE OSCAR/CERTIFICATIONOREGON
3122416MEDICAIDOREGON

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: 11/21/2025

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