Healthcare Provider Details

I. General information

NPI: 1811575079
Provider Name (Legal Business Name): OUR COMMUNITY BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 W B ST STE O
SPRINGFIELD OR
97477-4593
US

IV. Provider business mailing address

188 W B ST STE O
SPRINGFIELD OR
97477-4593
US

V. Phone/Fax

Practice location:
  • Phone: 541-746-2754
  • Fax:
Mailing address:
  • Phone: 458-234-6800
  • Fax: 458-200-4221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRIA WESTLAKE
Title or Position: EXECUTIVE DIRECTOR
Credential: CNM
Phone: 458-234-6800