Healthcare Provider Details

I. General information

NPI: 1093931925
Provider Name (Legal Business Name): CLEAR CHOICE HEALTH PLANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 NE COURTNEY DR
BEND OR
97701-7636
US

IV. Provider business mailing address

2650 NE COURTNEY DR
BEND OR
97701-7636
US

V. Phone/Fax

Practice location:
  • Phone: 541-385-5315
  • Fax: 541-385-3008
Mailing address:
  • Phone: 541-385-5315
  • Fax: 541-385-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER A BRADY
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 541-330-8115