Organization
MOSAIC MEDICAL
Active
Parent organization
MOSAIC MEDICAL
Other names
Mosaic Medical Complex Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOSAIC MEDICAL
Authorized official
MEGAN HAASE FNP (CEO)
(541) 383-3005
Entity
Organization
Contact information
Practice address
2065 NE TUCSON WAY APT 110, BEND, OR 97701-5182
(541) 419-1607
(541) 383-1883
Mailing address
600 SW COLUMBIA ST, SUITE 6210, BEND, OR 97702-1099
(541) 323-3181
(541) 706-9895
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182960
—
OR
Enumeration date
07/16/2013
Last updated
04/05/2022
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