Healthcare Provider Details

I. General information

NPI: 1346218252
Provider Name (Legal Business Name): KLAMATH WALK IN CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 SHASTA WAY SUITE #7
KLAMATH FALLS OR
97603-4455
US

IV. Provider business mailing address

2655 SHASTA WAY SUITE #7
KLAMATH FALLS OR
97603-4455
US

V. Phone/Fax

Practice location:
  • Phone: 541-882-2118
  • Fax: 541-882-0617
Mailing address:
  • Phone: 541-882-2118
  • Fax: 541-882-0617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN A PUFFENBARGER
Title or Position: CEO
Credential: FNP
Phone: 541-882-2118