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General NPI Number Information
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NPI Number | 1306511183
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Entity Type | Organization
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Legal Business Name | SOUTH WASCO COMMUNITY HEALTH
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 505 DESCHUTES AVE
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City | MAUPIN
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State | OR
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Zip | 97037-7002
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Country | US
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Telephone | 541-993-4650
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Fax |
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Provider Business Mailing Address
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Address Line | 142 S LOUISA RD
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City | TYGH VALLEY
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State | OR
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Zip | 97063-9742
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Country | US
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Telephone | 541-993-4650
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CHERYL C LAPLANTE
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Credential | DO
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Telephone | 541-993-4650
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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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