Healthcare Provider Details

I. General information

NPI: 1487753273
Provider Name (Legal Business Name): VILLAGE HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 COBURG RD STE 2 BLDG 4
EUGENE OR
97401-4900
US

IV. Provider business mailing address

1755 COBURG RD STE 2 BLDG 4
EUGENE OR
97401-4900
US

V. Phone/Fax

Practice location:
  • Phone: 541-684-3988
  • Fax: 541-686-2279
Mailing address:
  • Phone: 541-684-3988
  • Fax: 541-686-2279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT0481
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number272901
License Number StateOR

VIII. Authorized Official

Name: DAWN GANDALF
Title or Position: VICE-PRESIDENT
Credential: MHS, MAC, CADCIII
Phone: 541-684-3988