Organization
COW CREEK HEALTH & WELLNESS ANNEX
Active
Other names
COW CREEK HEALTH & WELLNESS ANNEX
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON A STANPHILL (CHIEF HEALTH OFFICER)
(541) 672-8533
Entity
Organization
Contact information
Practice address
270 GAZLEY BRIDGE RD, CANYONVILLE, OR 97417-9718
(541) 839-1345
(855) 670-1791
Mailing address
270 GAZLEY BRIDGE RD, CANYONVILLE, OR 97417-9718
(541) 839-1345
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
OR
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500745176
—
OR
Enumeration date
10/29/2009
Last updated
08/05/2021
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