| Holy Family Catholic Clinic, P.s. | |
|
21810 Willamette Dr West Linn OR 97068-3256 | |
| (503) 994-4353 | |
| Not Available |
| Full Name | Holy Family Catholic Clinic, P.s. |
|---|---|
| Speciality | Family Medicine |
| Location | 21810 Willamette Dr, West Linn, Oregon |
| Authorized Official Name and Position | Jessica Jose (BUSINESS MANAGER) |
| Authorized Official Contact | 5039944353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Family Catholic Clinic, P.s. 21810 Willamette Dr West Linn OR 97068-3256 Ph: (503) 994-4353 | Holy Family Catholic Clinic, P.s. 21810 Willamette Dr West Linn OR 97068-3256 Ph: (503) 994-4353 |
| NPI Number | 1619588175 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 08/10/2020 |
| Medicare PECOS PAC ID | 4587083779 |
|---|---|
| Medicare Enrollment ID | O20201008000826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619588175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Michael G Sherman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205866589 PECOS PAC ID: 0547256869 Enrollment ID: I20040422000691 |
| Provider Name | William L Toffler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891700308 PECOS PAC ID: 4284792250 Enrollment ID: I20081020000378 |
| Provider Name | Mary F Conedera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942433933 PECOS PAC ID: 6406991140 Enrollment ID: I20100304000955 |
| Provider Name | Kristin J Burgher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356598239 PECOS PAC ID: 9638358963 Enrollment ID: I20110119000586 |
| Provider Name | Grace E Jazrawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720213366 PECOS PAC ID: 7113177262 Enrollment ID: I20171020001317 |
| Provider Name | James C Trott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053806653 PECOS PAC ID: 9931532025 Enrollment ID: I20191203002730 |
| Provider Name | Mark F Mailhot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861534075 PECOS PAC ID: 7113020173 Enrollment ID: I20191218001354 |
| Provider Name | Benedicta Nneoma Nnodum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467972273 PECOS PAC ID: 0648544171 Enrollment ID: I20201103002255 |
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