# THE WELLNESS CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1184895518
- **Authorized official:** KIM D HAMMER (OFFICE MANAGER)
- **Authorized official phone:** (541) 957-5750

## Contact information

- **Practice address:** 2395 NW STEWART PKWY, ROSEBURG, OR 97470-5653
- **Practice address phone:** (541) 957-5750
- **Practice address fax:** (541) 957-5766
- **Mailing address:** 2395 NW STEWART PARKWAY, ROSEBURG, OR 97470
- **Mailing address phone:** (541) 957-5750
- **Mailing address fax:** (541) 957-5766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MD21306 | OR | Yes |

## Other

- **Enumeration date:** 03/13/2008
- **Last updated:** 03/13/2008