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Organization
COUNTY OF LAKE
Active
Organization
COUNTY OF LAKE
Active
Other names
Lake County Public Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY L WILKIE RN, BSN (ADMINISTRATOR)
(541) 947-6045
Entity
Organization
Contact information
Practice address
100 N D ST, SUITE 100, LAKEVIEW, OR 97630-1540
(541) 947-6045
(541) 947-4563
Mailing address
100 N D ST, SUITE 100, LAKEVIEW, OR 97630-1540
(541) 947-6045
(541) 947-4563
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
—
OR
251B00000X
Case Management Agency
93-60023202
OR
261QA0005X
Ambulatory Family Planning Facility
—
OR
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
OR
Other
Enumeration date
09/06/2006
Last updated
07/21/2022
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