Healthcare Provider Details

I. General information

NPI: 1245661636
Provider Name (Legal Business Name): VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 08/19/2023
Certification Date: 08/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 E HANCOCK ST
NEWBERG OR
97132-2145
US

IV. Provider business mailing address

PO BOX 6149
ALOHA OR
97007-0149
US

V. Phone/Fax

Practice location:
  • Phone: 971-281-3000
  • Fax: 503-537-0141
Mailing address:
  • Phone: 971-281-3000
  • Fax: 503-537-0141

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: ANNMARIE DENNIS
Title or Position: CORPORATE COMPLIANCE OFFICER
Credential:
Phone: 503-214-1652