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DALLAS FAMILY MEDICINE LLC NPI 1942292891


NPI Information

NPI: 1942292891
Provider Name: DALLAS FAMILY MEDICINE LLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 38D2232173

Address:
641 SE MILLER AVE
DALLAS, OR
ZIP 97338
Phone: (503) 623-2345
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DALLAS FAMILY MEDICINE LLC is a specialist in Dallas, OR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DALLAS FAMILY MEDICINE LLC NPI is 1942292891. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

641 SE MILLER AVE
DALLAS, OR
ZIP 97338-634
Phone: (503) 623-2345
Fax: (503) 623-6071

The provider's authorized official is Christopher W Edwardson .
The authorized official title is Sole Member and has the following contact phone number (503) 623-2345.

The CLIA number assigned to this NPI record is 38D2232173 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2005 and was last updated on 10/22/2012.


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
1174400000XSpecialistMD13699OREGONYes

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

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