Healthcare Provider Details
I. General information
NPI: 1144954215
Provider Name (Legal Business Name): RIMC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2022
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1245 NW 4TH ST STE 201
REDMOND OR
97756-1680
US
IV. Provider business mailing address
1245 NW 4TH ST STE 201
REDMOND OR
97756-1680
US
V. Phone/Fax
- Phone: 541-323-4545
- Fax: 541-323-4546
- Phone: 541-323-4545
- Fax: 541-323-4546
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORI
MCMILLIAN
Title or Position: FNP/OWNER
Credential: FNP
Phone: 541-323-4540