Healthcare Provider Details

I. General information

NPI: 1912832478
Provider Name (Legal Business Name): OREGON TRUSTED LOCAL CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 WILLAMETTE ST
EUGENE OR
97401-4045
US

IV. Provider business mailing address

1712 WILLAMETTE ST
EUGENE OR
97401-4045
US

V. Phone/Fax

Practice location:
  • Phone: 541-636-9393
  • Fax: 541-314-9553
Mailing address:
  • Phone: 541-636-9393
  • Fax: 541-314-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EMILY GRIFFITH
Title or Position: OWNER
Credential: NP-C
Phone: 541-636-9393