Bear Valley Medical Clinic
Nurse Practitioner in Grants Pass, OR. Organization (NPI-2).
NPI number1780287342
StatusActive
Last updated in NPPESDec 15, 2020
Details
- NPI
- 1780287342
- Entity type
- Organization (NPI-2)
- Legal business name
- Bear Valley Medical Clinic
- Organization subpart
- No
- Enumeration date
- Nov 17, 2020
- Certification date
- Dec 15, 2020
- Last updated
- Dec 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
1833 Nebraska AveGrants Pass, OR 97527-5701
Phone 541-226-9840
Mailing address
1833 Nebraska AveGrants Pass, OR 97527-5701
Phone 541-226-9840
Authorized official
Cherie Tibbits
Clinic Manager
5418213522
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