Organization
DR ANNA LLC
Active
Other names
Canyonville Health and Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIE DEBACA (OFFICE MANAGER)
(541) 391-4053
Entity
Organization
Contact information
Practice address
115 S PINE ST, CANYONVILLE, OR 97417-9648
(541) 839-4211
(541) 839-4983
Mailing address
PO BOX 888, CANYONVILLE, OR 97417-0888
(541) 839-4211
(541) 839-4983
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD26035
OR
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R141355
MEDICARE
OR
Enumeration date
10/10/2014
Last updated
06/07/2022
Update your record
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