Provider Demographics
NPI:1083970768
Name:GHC INC
Entity Type:Organization
Organization Name:GHC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:DONGVILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LLA
Authorized Official - Phone:503-630-6555
Mailing Address - Street 1:165 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-8580
Mailing Address - Country:US
Mailing Address - Phone:503-630-6555
Mailing Address - Fax:503-630-2838
Practice Address - Street 1:165 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-8580
Practice Address - Country:US
Practice Address - Phone:503-630-6555
Practice Address - Fax:503-630-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty