# WHITE CITY CBOC

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

## Provider details

- **NPI number:** 1871537258
- **Authorized official:** BARBARA MAYERICK (DIRECTOR, BUSINESS DEVELOPMENT)
- **Authorized official phone:** (202) 254-0339

## Contact information

- **Practice address:** 8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
- **Practice address phone:** (541) 826-2111
- **Practice address fax:** (541) 830-3500
- **Mailing address:** 8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
- **Mailing address phone:** (541) 826-2111
- **Mailing address fax:** (541) 830-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 08/22/2020