Healthcare Provider Details

I. General information

NPI: 1881577146
Provider Name (Legal Business Name): THE GYNECOLOGY COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 NE PENN AVE
BEND OR
97701-4255
US

IV. Provider business mailing address

180 NE PENN AVE
BEND OR
97701-4255
US

V. Phone/Fax

Practice location:
  • Phone: 505-250-3295
  • Fax:
Mailing address:
  • Phone: 505-250-3295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN DOKE-MAGRUDER
Title or Position: FNP/ PROVIDER/OWNER
Credential: FNP
Phone: 505-250-3295