Organization
KLAMTH HEALTH PARTNERSHIP
Active
Other names
Klamath Open Door Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANA SUE BEAL (AA)
(541) 880-2011
Entity
Organization
Contact information
Practice address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 880-2011
(541) 885-5512
Mailing address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 880-2011
(541) 885-5512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1115143
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1115143
PA
OR
Enumeration date
05/30/2014
Last updated
05/30/2014
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