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General NPI Number Information
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NPI Number | 1801386677
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Entity Type | Organization
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Legal Business Name | CANYON FAMILY HEALTH INC
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1095 N 1ST AVE
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City | STAYTON
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State | OR
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Zip | 97383-1203
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Country | US
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Telephone | 503-767-3226
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Fax | 503-767-3227
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Provider Business Mailing Address
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Address Line | 1095 N 1ST AVE
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City | STAYTON
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State | OR
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Zip | 97383-1203
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Country | US
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Telephone | 503-767-3226
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Fax | 503-767-3227
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Authorized Official
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Title or Position | OWNER
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Name | MARIA FIFE
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Credential | NP
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Telephone | 503-767-3226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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