Healthcare Provider Details

I. General information

NPI: 1811539448
Provider Name (Legal Business Name): PREGNANCY CARE CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 SW 2ND AVE
CANBY OR
97013-4152
US

IV. Provider business mailing address

158 SW 2ND AVE
CANBY OR
97013-4152
US

V. Phone/Fax

Practice location:
  • Phone: 503-266-2673
  • Fax:
Mailing address:
  • Phone: 503-266-2673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDA FENDER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 503-266-2673