Provider Demographics
NPI:1306207006
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:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMREY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:541-474-5511
Mailing Address - Street 1:1619 NW HAWTHORNE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-6009
Mailing Address - Country:US
Mailing Address - Phone:541-474-5511
Mailing Address - Fax:
Practice Address - Street 1:1619 NW HAWTHORNE AVE STE 203
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-6009
Practice Address - Country:US
Practice Address - Phone:541-474-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201601213NP-PP261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care