Healthcare Provider Details
I. General information
NPI: 1487784500
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF SOUTHWESTERN OREGON
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2007
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1450 BIRCH AVE
COTTAGE GROVE OR
97424-1417
US
IV. Provider business mailing address
3579 FRANKLIN BLVD
EUGENE OR
97403-2356
US
V. Phone/Fax
- Phone: 541-344-2632
- Fax: 541-344-6519
- Phone: 541-344-2632
- Fax: 541-344-6519
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
KELLY
HALL
Title or Position: DIRECTOR OF PATIENT SERVICES
Credential:
Phone: 541-344-2632