Healthcare Provider Details

I. General information

NPI: 1487919783
Provider Name (Legal Business Name): AURORA FAMILY HEALTH AND MATERNITY CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21358 HWY 99E NE
AURORA OR
97002
US

IV. Provider business mailing address

21358 HWY 99E NE
AURORA OR
97002
US

V. Phone/Fax

Practice location:
  • Phone: 503-678-6269
  • Fax: 503-217-1599
Mailing address:
  • Phone: 503-678-6269
  • Fax: 503-217-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN ANN CORCORAN
Title or Position: OWNER
Credential: FNP, CNM
Phone: 503-678-6269