Healthcare Provider Details

I. General information

NPI: 1659328367
Provider Name (Legal Business Name): WILLAMETTE COMMUNITY HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

996 JEFFERSON ST
EUGENE OR
97402-5225
US

IV. Provider business mailing address

2650 SUZANNE WAY SUITE 200
EUGENE OR
97408-7319
US

V. Phone/Fax

Practice location:
  • Phone: 541-726-4484
  • Fax: 541-744-8477
Mailing address:
  • Phone: 541-228-3000
  • Fax: 541-228-3180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHERYL BOYUM
Title or Position: CEO
Credential:
Phone: 541-726-4484