| NPI | 1912061755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MONET WATSON COO 541-492-4550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261Q00000X Clinic/Center (Licence: OR 276245) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2025-10-14 |