Provider Demographics
NPI:1124396429
Name:WEST LINN PRIMARY CARE, P.C
Entity Type:Organization
Organization Name:WEST LINN PRIMARY CARE, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-636-1133
Mailing Address - Street 1:18670 WILLAMETTE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-1796
Mailing Address - Country:US
Mailing Address - Phone:503-636-1133
Mailing Address - Fax:503-636-1331
Practice Address - Street 1:18670 WILLAMETTE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-1796
Practice Address - Country:US
Practice Address - Phone:503-636-1133
Practice Address - Fax:503-636-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR063016Medicaid