Healthcare Provider Details

I. General information

NPI: 1437187614
Provider Name (Legal Business Name): REDMOND IMMEDIATE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3818 SW 21ST PL SUITE 100
REDMOND OR
97756-7771
US

IV. Provider business mailing address

PO BOX 1770
REDMOND OR
97756-0519
US

V. Phone/Fax

Practice location:
  • Phone: 541-548-2899
  • Fax: 541-504-3781
Mailing address:
  • Phone: 541-923-4576
  • Fax: 541-923-4976

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: SHERREL A STEPHENS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 541-923-4576