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Organization
WILLOW WOMEN AND CHILDREN'S WELLNESS, LLC
Active
Organization
WILLOW WOMEN AND CHILDREN'S WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CORCORAN (OWNER)
(503) 678-6269
Entity
Organization
Contact information
Practice address
5665 WILSHIRE BLVD STE 1609, LOS ANGELES, CA 90036-3710
(424) 600-8360
Mailing address
21358 HIGHWAY 99E NE, AURORA, OR 97002-9201
(503) 678-6269
(503) 217-1599
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150392091
CORPORATION DIVISION FILLING IN OREGON
OR
Enumeration date
12/27/2018
Last updated
05/13/2025
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