Provider Demographics
NPI:1457842833
Name:VALLEY CLINICS
Entity Type:Organization
Organization Name:VALLEY CLINICS
Other - Org Name:VALLEY CLINICS INTERNAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-758-0766
Mailing Address - Street 1:981 NW SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-2111
Mailing Address - Country:US
Mailing Address - Phone:541-758-0766
Mailing Address - Fax:541-753-2737
Practice Address - Street 1:981 NW SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-2111
Practice Address - Country:US
Practice Address - Phone:541-758-0766
Practice Address - Fax:541-753-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty