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General NPI Number Information
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NPI Number | 1033173604
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Entity Type | Organization
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Legal Business Name | WILLAMETTE VALLEY CLINICS LLC
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 222 SE JEFFERSON ST
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City | SHERIDAN
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State | OR
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Zip | 97378-1924
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Country | US
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Telephone | 503-843-4909
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 COMMERCE WAY STE. 180
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City | BRENTWOOD
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State | TN
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Zip | 37027-2829
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Country | US
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Telephone | 615-465-7626
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Fax | 615-465-3007
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Authorized Official
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Title or Position | SECRETARY
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Name | CHARLOTTE LAWRENCE
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Credential |
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Telephone | 615-920-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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