Provider Demographics
NPI:1447401203
Name:WILLAMETTE COMMUNITY HEALTH
Entity Type:Organization
Organization Name:WILLAMETTE COMMUNITY HEALTH
Other - Org Name:WILLAMETTE COMMUNITY HEALTH DIRECTION EAP
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-345-2800
Mailing Address - Street 1:66 CLUB RD
Mailing Address - Street 2:STE 120
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-345-2800
Mailing Address - Fax:541-345-4419
Practice Address - Street 1:66 CLUB RD
Practice Address - Street 2:STE 120
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-345-2800
Practice Address - Fax:541-345-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)