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1401 N 10th Ave Ste. 100 Stayton OR 97383-1486 | |
(503) 769-6386 | |
(503) 769-5647 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1401 N 10th Ave, Stayton, Oregon |
Authorized Official Name and Position | Lynda Fraser (CLINIC DIRECTOR) |
Authorized Official Contact | 5037699254 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1401 N 10th Ave Ste. 100 Stayton OR 97383-1486 Ph: (503) 769-6386 | 1401 N 10th Ave Ste. 100 Stayton OR 97383-1486 Ph: (503) 769-6386 |
NPI Number | 1477909570 |
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Provider Enumeration Date | 05/06/2016 |
Last Update Date | 10/22/2018 |
Medicare PECOS PAC ID | 6103729751 |
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Medicare Enrollment ID | O20180328002926 |
Identifier | Type | State | Issuer |
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1477909570 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Jeanne L Fitzpatrick Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 N 10th Ave Ste 100, Stayton, OR 97383 Phone: 503-769-4602 Fax: 503-769-5416 | |
Patrick R. Arden D.c.p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 E Washington St, Stayton, OR 97383 Phone: 503-769-2801 | |