# ICCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eugene Urgent Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700251154
- **Authorized official:** SUSAN LAVERN HUNSUCKER (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (541) 521-7222

## Contact information

- **Practice address:** 1292 HIGH STREET, SUITE 224, EUGENE, OR 97401
- **Practice address phone:** (541) 345-8760
- **Practice address fax:** (541) 345-8763
- **Mailing address:** 1292 HIGH ST, SUITE 224, EUGENE, OR 97401-3238
- **Mailing address phone:** (541) 345-2860
- **Mailing address fax:** (541) 345-8763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | PA175527 | OR | Yes |

## Other

- **Enumeration date:** 12/10/2015
- **Last updated:** 12/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PA175527 | OREGON MEDICAL BOARD STATE LICENSE FOR PHYSICIAN ASSISTANT | OR |