Healthcare Provider Details

I. General information

NPI: 1659434462
Provider Name (Legal Business Name): CENTER FOR WOMEN & THE FAMILY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 SE COURT PL
PENDLETON OR
97801-3220
US

IV. Provider business mailing address

1304 SE COURT PL
PENDLETON OR
97801-3220
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-0108
  • Fax:
Mailing address:
  • Phone: 541-278-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD26356
License Number StateOR

VIII. Authorized Official

Name: DR. JULIET K MARKHAM
Title or Position: OWNER
Credential: MD
Phone: 541-278-0108