Healthcare Provider Details

I. General information

NPI: 1750296406
Provider Name (Legal Business Name): VINA MOSES WELFARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 NW GARFIELD AVE
CORVALLIS OR
97330-2116
US

IV. Provider business mailing address

968 NW GARFIELD AVE
CORVALLIS OR
97330-2116
US

V. Phone/Fax

Practice location:
  • Phone: 541-753-1420
  • Fax:
Mailing address:
  • Phone: 541-753-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: ILENE MCCLELLAND
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 541-753-1420