Organization
CANBY HEALTHCARE CLINIC LLC
Active
Other names
Canby Healthcare Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULINE L RICHARDS MANAGER (OWNER)
(503) 266-7686
Entity
Organization
Contact information
Practice address
703 SE 1ST AVE, CANBY, OR 97013-3849
(503) 266-7686
(503) 266-7382
Mailing address
703 SE 1ST AVE, CANBY, OR 97013-3849
(503) 266-7686
(503) 266-7382
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500618933
—
OR
Enumeration date
11/02/2009
Last updated
02/14/2013
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