Organization
KLAMATH HEALTH PARTNERSHIP INC
Active
Parent organization
KLAMATH HEALTH PARTNERSHIP INC
Other names
Pine Street Open Door
Organization subpart
Yes
Provider details
NPI number
Legal business name
KLAMATH HEALTH PARTNERSHIP INC
Authorized official
JEANA MASTERS (RO)
(541) 880-2011
Entity
Organization
Contact information
Practice address
403 PINE ST, KLAMATH FALLS, OR 97601-6020
(541) 851-8110
Mailing address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 851-8110
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170061
—
OR
01
—
R101150
MEDICARE-B
OR
Enumeration date
06/06/2022
Last updated
02/06/2023
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