Organization
LOWER UMPQUA HOSPITAL DISTRICT
Active
Other names
Dunes Family Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHON CHIVERS (CEO)
(541) 271-6313
Entity
Organization
Contact information
Practice address
620 RANCH RD, REEDSPORT, OR 97467
(541) 271-2163
(541) 271-4058
Mailing address
600 RANCH RD, REEDSPORT, OR 97467-1720
(541) 271-2171
(541) 271-6380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276263
—
OR
01
—
R0000ZGBKR
MEDICARE PART B PTAN
OR
Enumeration date
07/08/2006
Last updated
01/18/2023
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