MEDICARE: COUNTY OF LINCOLN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251K00000X	Public Health or Welfare Agency
2	261QP0905X	State or Local Public Health Clinic/Center
3	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710123906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF LINCOLN

Provider Business Mailing Address
First Line	:	36 SW NYE ST
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-3821
Country	:	US
Telephone Number	:	541-265-0468
Fax Number	:	541-265-0443

Provider Business Practice Location Address
First Line	:	255 SW COAST HWY
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-4988
Country	:	US
Telephone Number	:	541-265-0457
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	LESA WAGNER
Credential	:
Telephone Number	:	541-265-0445

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	08/08/2025

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Directions to “COUNTY OF LINCOLN ” Practice Location

Language	Start Address	Practice Location

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