Village Healthcare Of La Grande, Inc.
May also be knows as Village Healthcare Of Corvallis
Clinic/Center in Corvallis, OR(View on Map)
Legal Business Name
Village Healthcare Of La Grande, Inc.
Also Known As
Village Healthcare Of Corvallis
NPI Number
1154555076
NPI Type
Organization
Enumeration Date
05/06/2009
Specialties
(Taxonomies)Licenses
State
Oregon
License Number
200450130NP
Contact
Information
Purpose
Mailing
Location
Address
656 NW MIRADOR PL
656 NW MIRADOR PL
City
Corvallis
Corvallis
State
OR
OR
Postal Code
97330-4698
97330-4698
Country
US
US
Telephone Number
(541) 552-0386
(541) 624-2040
Authorized Official
Name
Renee Edwards
Title or Position
MANAGER PROVIDER PRESIDENT
Telephone Number
(541) 552-0386
Identifiers
Identifier
131713
269505
Identifier State
OR
OR
Identifier Issuer
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/19/2019
Provider Address
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