Healthcare Provider Details

I. General information

NPI: 1568546570
Provider Name (Legal Business Name): NEHALEM BAY HEALTH CENTER AND PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 NEHALEM BLVD
WHEELER OR
97147-0176
US

IV. Provider business mailing address

P.O. BOX 176
WHEELER OR
97147-0176
US

V. Phone/Fax

Practice location:
  • Phone: 503-368-5182
  • Fax: 503-368-7328
Mailing address:
  • Phone: 503-368-5182
  • Fax: 503-368-7328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number136296
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GAIL NELSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 800-368-5182