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Organization
WHITE OAK MEDICAL CLINIC LLC
Active
Organization
WHITE OAK MEDICAL CLINIC LLC
Active
Other names
White Oak Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE BOLDUC (PRESIDENT)
(541) 464-5907
Entity
Organization
Contact information
Practice address
340 NW MEDICAL LOOP, ROSEBURG, OR 97471-1645
(541) 464-5907
Mailing address
340 NW MEDICAL LOOP, ROSEBURG, OR 97471-1645
(541) 464-5907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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