Voda Integrative Medical Clinic LLC
Nurse Practitioner, Family in Newberg, OR. Organization (NPI-2).
NPI number1669931499
StatusActive
Last updated in NPPESApr 30, 2020
Details
- NPI
- 1669931499
- Entity type
- Organization (NPI-2)
- Legal business name
- Voda Integrative Medical Clinic LLC
- Organization subpart
- No
- Enumeration date
- Mar 19, 2019
- Certification date
- Apr 30, 2020
- Last updated
- Apr 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – | |
| 363LW0102X | Nurse Practitioner, Women's Health | – | – |
Other names
- Voda Integrative Medical Clinic (Doing Business As)
Practice location
434 Villa RdNewberg, OR 97132-1855
Phone 309-620-4438
Mailing address
440 N Villa RdNewberg, OR 97132-1856
Authorized official
Chelsea Deselms
Nurse Practitioner
5034761431
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