Provider Demographics
NPI:1174190961
Name:ONE FAMILY MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:ONE FAMILY MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTIOITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMREY
Authorized Official - Suffix:
Authorized Official - Credentials:NPC
Authorized Official - Phone:541-474-5511
Mailing Address - Street 1:1585 NW WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1049
Mailing Address - Country:US
Mailing Address - Phone:541-474-5511
Mailing Address - Fax:541-472-3225
Practice Address - Street 1:1585 NW WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1049
Practice Address - Country:US
Practice Address - Phone:541-474-5511
Practice Address - Fax:541-472-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty