# CLATSKANIE FAMILY MEDICAL CLINIC, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1740504422
- **Authorized official:** WILLIAM DENNIS-LEIGH (PRESIDENT)
- **Authorized official phone:** (503) 728-5111

## Contact information

- **Practice address:** 401 BELAIR DRIVE, CLATSKANIE, OR 97016
- **Practice address phone:** (503) 728-5111
- **Mailing address:** PO BOX 821350, VANCOUVER, WA 98682-0030
- **Mailing address phone:** (866) 622-2455
- **Mailing address fax:** (800) 734-4829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | — | NULL | Yes |
| 363AM0700X | Medical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 03/24/2010
- **Last updated:** 08/31/2011