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General NPI Number Information
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NPI Number | 1376412486
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Entity Type | Organization
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Legal Business Name | VIRGINIA GARCIA MEMORIAL HEALTH CENTER
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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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 | 503-357-4371
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6149
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City | ALOHA
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State | OR
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Zip | 97007-0149
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | KRISTEN LONG
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Credential |
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Telephone | 503-352-8682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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