# CLATSKANIE FAMILY HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164637641
- **Authorized official:** LARRY ALLEN DAVIS (ADMINISTRATOR)
- **Authorized official phone:** (503) 728-0424

## Contact information

- **Practice address:** 401 SW BEL AIR, CLATSKANIE, OR 97016-0927
- **Practice address phone:** (503) 728-0424
- **Practice address fax:** (503) 728-1297
- **Mailing address:** PO BOX 927, 401 SW BEL AIR, CLATSKANIE, OR 97016-0927
- **Mailing address phone:** (503) 728-0424
- **Mailing address fax:** (503) 728-1297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 0713 | OR | Yes |
| 363LF0000X | Family Nurse Practitioner | — | OR | — |
| 363LP0200X | Pediatric Nurse Practitioner | 000038358N2 | OR | — |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 277982 | — | OR |