| Willamette Clinic, Llc | |
|
1750 Blankenship Road Suite 280 West Linn OR 97068-8269 | |
| (503) 496-0290 | |
| (503) 496-3166 |
| Full Name | Willamette Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1750 Blankenship Road, West Linn, Oregon |
| Authorized Official Name and Position | Sheri L Laird (OWNER) |
| Authorized Official Contact | 5034960290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willamette Clinic, Llc 1750 Blankenship Road Suite 280 West Linn OR 97068-8269 Ph: (503) 496-0290 | Willamette Clinic, Llc 1750 Blankenship Road Suite 280 West Linn OR 97068-8269 Ph: (503) 496-0290 |
| NPI Number | 1821268822 |
|---|---|
| Provider Enumeration Date | 03/05/2008 |
| Last Update Date | 05/11/2009 |
| Medicare PECOS PAC ID | 1254400682 |
|---|---|
| Medicare Enrollment ID | O20090518000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821268822 | NPI | - | NPPES |
| 134282 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD21936 (Oregon) | Primary |
| Provider Name | Sheri L Laird |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891731733 PECOS PAC ID: 7315924602 Enrollment ID: I20040706000201 |
West Linn Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18380 Willamette Dr, Suite 202, West Linn, OR 97068 Phone: 503-635-8384 Fax: 503-636-6475 | |
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