Organization
THE CORVALLIS CLINIC P C
Active
Parent organization
THE CORVALLIS CLINIC P C
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CORVALLIS CLINIC P C
Authorized official
MR. JAMES KAECH (CEO)
(541) 754-1374
Entity
Organization
Contact information
Practice address
601 NW ELKS DRIVE, CORVALLIS, OR 97330-3781
(541) 754-1254
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043158
—
OR
05
—
500600864
—
OR
Enumeration date
08/04/2008
Last updated
08/23/2024
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