Healthcare Provider Details

I. General information

NPI: 1376504316
Provider Name (Legal Business Name): THE WOMEN'S CENTER OF CENTRAL OREGON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 NW CANAL BLVD
REDMOND OR
97756-1420
US

IV. Provider business mailing address

1001 NW CANAL BLVD
REDMOND OR
97756-1420
US

V. Phone/Fax

Practice location:
  • Phone: 541-504-7635
  • Fax: 541-923-5902
Mailing address:
  • Phone: 541-504-7635
  • Fax: 541-923-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD22835
License Number StateOR

VIII. Authorized Official

Name: MRS. DONNA FISHER
Title or Position: OFFICE MANAGER
Credential:
Phone: 541-923-5879