Healthcare Provider Details

I. General information

NPI: 1154456002
Provider Name (Legal Business Name): CHOICES FOR HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 W 12TH AVE
EUGENE OR
97401-3301
US

IV. Provider business mailing address

1510 MILL ST
EUGENE OR
97401-4258
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-4404
  • Fax: 541-683-4405
Mailing address:
  • Phone: 541-431-1201
  • Fax: 541-683-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GAYLE ANN HAND
Title or Position: PRESIDENTSECRETARY
Credential: ANP
Phone: 541-431-1201