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General NPI Number Information
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NPI Number | 1245428903
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Entity Type | Organization
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Legal Business Name | OREGON FAMILY HEALTH, LLC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 607 SE JEFFERSON ST
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City | DALLAS
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State | OR
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Zip | 97338-2025
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Country | US
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Telephone | 503-623-1200
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Fax | 503-623-1414
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Provider Business Mailing Address
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Address Line | 607 SE JEFFERSON ST
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City | DALLAS
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State | OR
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Zip | 97338-2025
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Country | US
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Telephone | 503-623-1200
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Fax | 503-623-1414
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM DANIEL PEFFLEY
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Credential | DO
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Telephone | 503-623-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DO27471
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License Number State | OR
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