LWAFP PC INC NPI 1992951107

NPI Information

  • NPI: 1992951107
  • Provider Name: LWAFP PC INC
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Organization
  • Doing Business As: LIVING WATER ADULT FAMILY PRACTICE
  • Address: 181 NW BUNNELL AVE
    GRANTS PASS, OR
    ZIP 97526
  • Phone: (541) 474-9400

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NPI Details

LWAFP PC INC is an adult health nurse practitioner in Grants Pass, OR. LWAFP PC INC NPI is 1992951107. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Living Water Adult Family Practice.

The provider's business location address is:

181 NW BUNNELL AVE
GRANTS PASS, OR
ZIP 97526-012
Phone: (541) 474-9400

The provider's authorized official is Cynthia Mahoney .
The authorized official title is President and has the following contact phone number (541) 474-9400.

The enumeration date for this NPI number is 8/7/2008 and was last updated on 8/7/2008.

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
1363LA2200XNurse PractitionerAdult HealthYes

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: 3/30/2025

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