Healthcare Provider Details

I. General information

NPI: 1598928004
Provider Name (Legal Business Name): ASHER COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 JAY ST
FOSSIL OR
97830-0307
US

IV. Provider business mailing address

712 JAY ST
FOSSIL OR
97830-0307
US

V. Phone/Fax

Practice location:
  • Phone: 541-763-2725
  • Fax: 541-763-2850
Mailing address:
  • Phone: 541-763-2725
  • Fax: 541-763-2850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier276319
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: MR. JAMES CARLSON
Title or Position: ADMINISTRATOR
Credential: DC
Phone: 541-763-2725