MEDICARE: OSWEGO MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133N00000X	Nutritionist
2	163WG0000X	General Practice Registered Nurse
3	171400000X	Health & Wellness Coach
4	202D00000X	Integrative Medicine Physician
5	207Q00000X	Family Medicine Physician
6	363L00000X	Nurse Practitioner
7	363LP2300X	Primary Care Nurse Practitioner
8	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1376482570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSWEGO MEDICAL LLC

Provider Business Mailing Address
First Line	:	17050 PILKINGTON RD STE 220
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-6309
Country	:	US
Telephone Number	:	541-392-6226
Fax Number	:	541-325-4063

Provider Business Practice Location Address
First Line	:	17050 PILKINGTON RD STE 220
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-6309
Country	:	US
Telephone Number	:	541-392-6226
Fax Number	:	541-325-4063

Authorized Official
Title or Position	:	MANAGER
Name	:	JAMIE KEIG
Credential	:	MSN, FNP-C
Telephone Number	:	541-392-6226

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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