Healthcare Provider Details

I. General information

NPI: 1124396429
Provider Name (Legal Business Name): WEST LINN PRIMARY CARE, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18670 WILLAMETTE DR SUITE 101
WEST LINN OR
97068-1796
US

IV. Provider business mailing address

18670 WILLAMETTE DR SUITE 101
WEST LINN OR
97068-1796
US

V. Phone/Fax

Practice location:
  • Phone: 503-636-1133
  • Fax: 503-636-1331
Mailing address:
  • Phone: 503-636-1133
  • Fax: 503-636-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUEY J MEEKER
Title or Position: PRESIDENT
Credential: MD
Phone: 503-636-1133