Organization
COLUMBIACARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE DAVID SEWITSKY (FINANCE MANAGER)
(541) 858-8170
Entity
Organization
Contact information
Practice address
3587 HEATHROW WAY, SUITE #1, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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