Healthcare Provider Details

I. General information

NPI: 1245360361
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF SOUTHWESTERN OREGON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4969 HIGHWAY 101
FLORENCE OR
97439-7803
US

IV. Provider business mailing address

3579 FRANKLIN BLVD
EUGENE OR
97403-2356
US

V. Phone/Fax

Practice location:
  • Phone: 541-344-2632
  • Fax: 541-344-6519
Mailing address:
  • Phone: 541-344-2632
  • Fax: 541-344-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD21490
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License NumberMD12242
License Number StateOR

VIII. Authorized Official

Name: MS. KELLY HALL
Title or Position: DIRECTOR OF PATIENT SERVICES
Credential:
Phone: 541-344-2632