SUNRISE FAMILY CLINIC LLC NPI 1538594999

NPI Information

NPI: 1538594999
Provider Name: SUNRISE FAMILY CLINIC, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 38D2065291

Address:
351 SE BAKER ST
MCMINNVILLE, OR
ZIP 97128
Phone: (503) 474-3600
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SUNRISE FAMILY CLINIC, LLC is a primary care clinic center in Mcminnville, OR. SUNRISE FAMILY CLINIC, LLC NPI is 1538594999. The provider is registered as an organization entity type.

The provider's business location address is:

351 SE BAKER ST
MCMINNVILLE, OR
ZIP 97128-039
Phone: (503) 474-3600
Fax: (503) 474-3601

The provider's authorized official is Jacqualine Marie Terrill Cooke .
The authorized official title is Owner/provider and has the following contact phone number (503) 474-3600.

The CLIA number assigned to this NPI record is 38D2065291 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/4/2013 and was last updated on 9/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	200350072NP	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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