Healthcare Provider Details

I. General information

NPI: 1649431636
Provider Name (Legal Business Name): WILLAMETTE COMMUNITY HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SUZANNE WAY STE 200
EUGENE OR
97408-7619
US

IV. Provider business mailing address

2650 SUZANNE WAY STE 200
EUGENE OR
97408-7619
US

V. Phone/Fax

Practice location:
  • Phone: 541-228-3130
  • Fax: 541-228-3187
Mailing address:
  • Phone: 541-228-3130
  • Fax: 541-228-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN D MCNEAL
Title or Position: OCCUPATIONAL HEALTH SYSTEM MANAGER
Credential:
Phone: 541-228-3094