Organization
HEALTH PRACTITIONER CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTE GAY SEAGREN CFNP (OWNER)
(503) 263-6611
Entity
Organization
Contact information
Practice address
143 NW 4TH AVE, CANBY, OR 97013
(503) 263-6611
(503) 266-5674
Mailing address
143 NW 4TH AVE, CANBY, OR 97013
(503) 263-6611
(503) 266-5674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
000037573N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282467
—
OR
Enumeration date
11/22/2006
Last updated
11/01/2007
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