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Organization

THE CORVALLIS CLINIC PC

Active
Parent organization
CORVALLIS CLINIC PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CORVALLIS CLINIC PC
Authorized official
MR. JAMES KAECH (CEO)
(541) 754-1374
Entity
Organization

Contact information

Practice address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1150
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
38D0656873
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276663
OR
05
276671
OR
05
276697
OR
05
299481
OR
Enumeration date
08/14/2008
Last updated
07/11/2024
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