Organization
O'DONOVAN CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL J. O'DONOVAN (OWNER/MANAGER)
(503) 738-5571
Entity
Organization
Contact information
Practice address
580 AVENUE U, SEASIDE, OR 97138-5065
(503) 738-5571
(503) 738-5573
Mailing address
580 AVENUE U, SEASIDE, OR 97138-5065
(503) 738-5571
(503) 738-5573
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
00038357
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286279
—
OR
Enumeration date
12/22/2005
Last updated
02/12/2008
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