Organization
WESTERN OREGON SERVICE UNIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA HERBISON RN, BSN (CEO)
(503) 304-7642
Entity
Organization
Contact information
Practice address
3750 CHEMAWA RD NE, SALEM, OR 97305-1119
(503) 304-7600
Mailing address
11815 NE 60TH AVE, VANCOUVER, WA 98686-4585
(405) 439-3873
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
R0067049
OK
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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