# INDEPENDENCE-MONMOUTH FAMILY MEDICINE PC

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

## Provider details

- **NPI number:** 1598868515
- **Authorized official:** KEITH ALLEN WHITE MD (OFFICIAL REPRESENTATIVE)
- **Authorized official phone:** (503) 838-1133

## Contact information

- **Practice address:** 1430 MONMOUTH ST, INDEPENDENCE, OR 97351
- **Practice address phone:** (503) 838-1133
- **Practice address fax:** (503) 838-5138
- **Mailing address:** PO BOX 309, INDEPENDENCE, OR 97351
- **Mailing address phone:** (503) 838-1133
- **Mailing address fax:** (503) 838-5138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 11/04/2008