Organization
MIDDLE WAY HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA JOY KENDALL FNP (BOARD MEMBER/ FNP)
(530) 812-7367
Entity
Organization
Contact information
Practice address
2615 6TH ST, TILLAMOOK, OR 97141-4114
(503) 812-7367
Mailing address
2615 6TH ST, TILLAMOOK, OR 97141-4114
(503) 842-4809
(503) 842-8022
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
094006492N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245291756
NPI FOR LISA KENDALL FNP
OR
05
—
218477
—
OR
Enumeration date
10/15/2007
Last updated
06/16/2018
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