Healthcare Provider Details

I. General information

NPI: 1760935795
Provider Name (Legal Business Name): SAHALI HEALTH CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NW PROFESSIONAL DR STE 100
CORVALLIS OR
97330-3891
US

IV. Provider business mailing address

2211 NW PROFESSIONAL DR STE 100
CORVALLIS OR
97330-3891
US

V. Phone/Fax

Practice location:
  • Phone: 541-243-3671
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL MAY
Title or Position: CEO
Credential: M.D
Phone: 541-974-4414