Healthcare Provider Details

I. General information

NPI: 1831501436
Provider Name (Legal Business Name): KLAMATH HEALTH PARTNERSHIP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2014
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2074 S 6TH ST
KLAMATH FALLS OR
97601-3372
US

IV. Provider business mailing address

2074 S 6TH ST
KLAMATH FALLS OR
97601-3372
US

V. Phone/Fax

Practice location:
  • Phone: 541-880-2011
  • Fax: 541-885-5512
Mailing address:
  • Phone: 541-880-2011
  • Fax: 541-885-5512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEANA MASTERS
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 541-880-2011