Provider Demographics
NPI:1659328367
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:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-726-4484
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:541-228-3000
Mailing Address - Fax:541-228-3180
Practice Address - Street 1:996 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5225
Practice Address - Country:US
Practice Address - Phone:541-726-4484
Practice Address - Fax:541-744-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR569947Medicaid