FOUR RIVERS HEALTHCARE CLINIC; NPI #1588999007

Contact Information

FOUR RIVERS HEALTHCARE CLINIC

932 W IDAHO AVE STE 100
ONTARIO, OR 97914-2155

Phone: 541-889-2244
Fax: 541-889-2626
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Family Health	364SF0001X	89	Certified Clinical Nurse Specialist
Psychiatric/Mental Health	363LP0808X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for FOUR RIVERS HEALTHCARE CLINIC

NPI # 1588999007

LBN Legal business name FOUR RIVERS HEALTHCARE CLINIC

Authorized official JODY STARK - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/16/2009

Last updated 10/16/2009 - About 17 years ago

Identifiers

OR	License #	07904
OR	License #	200550081NP

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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FOUR RIVERS HEALTHCARE CLINIC

Contact Information

Specialty

Family Health

Psychiatric/Mental Health

NPI Profile & details for FOUR RIVERS HEALTHCARE CLINIC

Reviews for FOUR RIVERS HEALTHCARE CLINIC