# FIRST AVENUE CLINIC

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

## Provider details

- **NPI number:** 1710173190
- **Authorized official:** DR. DIANN LYNN FREASE N.D. (NATUROPATHIC PHYSICIAN)
- **Authorized official phone:** (503) 266-2000

## Contact information

- **Practice address:** 322 NW 1ST AVE, CANBY, OR 97013-3533
- **Practice address phone:** (503) 266-2000
- **Practice address fax:** (503) 266-2015
- **Mailing address:** 322 NW 1ST AVE, CANBY, OR 97013-3533
- **Mailing address phone:** (503) 266-2000
- **Mailing address fax:** (503) 266-2015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 1420 | OR | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 09/19/2007