Provider Demographics
NPI:1629147715
Name:WILLAMETTE COMMUNITY HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:WILLAMETTE COMMUNITY HEALTH SOLUTIONS
Other - Org Name:CASCADE HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIABETES EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNS
Authorized Official - Phone:541-228-3024
Mailing Address - Street 1:2650 SUZANNE WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7319
Mailing Address - Country:US
Mailing Address - Phone:541-228-3020
Mailing Address - Fax:541-228-3181
Practice Address - Street 1:2650 SUZANNE WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7319
Practice Address - Country:US
Practice Address - Phone:541-228-3020
Practice Address - Fax:541-228-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty