| Stayton Family Practice Inc | |
|
1881 W Washington St Stayton OR 97383-9511 | |
| (503) 400-6140 | |
| (503) 769-3797 |
| Full Name | Stayton Family Practice Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1881 W Washington St, Stayton, Oregon |
| Authorized Official Name and Position | Lance B Large (OWNER) |
| Authorized Official Contact | 5034006140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stayton Family Practice Inc 1881 W Washington St Stayton OR 97383-9511 Ph: (503) 400-6140 | Stayton Family Practice Inc 1881 W Washington St Stayton OR 97383-9511 Ph: (503) 400-6140 |
| NPI Number | 1912130915 |
|---|---|
| Provider Enumeration Date | 08/25/2009 |
| Last Update Date | 06/15/2022 |
| Medicare PECOS PAC ID | 6709922230 |
|---|---|
| Medicare Enrollment ID | O20091013000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912130915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lance B Large |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750362554 PECOS PAC ID: 0143110841 Enrollment ID: I20040317000524 |
| Provider Name | Richard Cutler Boughn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114088101 PECOS PAC ID: 0446382451 Enrollment ID: I20100709000239 |
Cascade Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1369 N 10th Ave, Stayton, OR 97383 Phone: 503-769-7546 Fax: 503-769-8563 | |
Guesly Dessieux, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 N 10th Ave, Suite 100, Stayton, OR 97383 Phone: 503-769-6386 | |
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 | |
Damian E. Jorgensen M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 N 10th Ave, Suite 200, Stayton, OR 97383 Phone: 503-769-9070 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 | |
Nancy Dougherty, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 N 10th Ave, Suite 200, Stayton, OR 97383 Phone: 503-769-9362 Fax: 503-769-5416 | |
Santiam Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1401 N 10th Ave, Ste. 100, Stayton, OR 97383 Phone: 503-769-6386 Fax: 503-769-5647 |