# COUNTY OF LAKE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake County Public Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376646380
- **Authorized official:** MRS. MARY L WILKIE RN, BSN (ADMINISTRATOR)
- **Authorized official phone:** (541) 947-6045

## Contact information

- **Practice address:** 100 N D ST, SUITE 100, LAKEVIEW, OR 97630-1540
- **Practice address phone:** (541) 947-6045
- **Practice address fax:** (541) 947-4563
- **Mailing address:** 100 N D ST, SUITE 100, LAKEVIEW, OR 97630-1540
- **Mailing address phone:** (541) 947-6045
- **Mailing address fax:** (541) 947-4563

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | OR | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 07/21/2022