Provider Demographics
NPI:1659968279
Name:WOMENS HEALTH AND WELLNESS CLINIC LLC
Entity Type:Organization
Organization Name:WOMENS HEALTH AND WELLNESS CLINIC LLC
Other - Org Name:ESSENTIAL HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NP / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:541-690-1215
Mailing Address - Street 1:3502 EXCEL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9135
Mailing Address - Country:US
Mailing Address - Phone:541-690-1215
Mailing Address - Fax:541-500-3309
Practice Address - Street 1:3502 EXCEL DR STE 101
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9135
Practice Address - Country:US
Practice Address - Phone:541-690-1215
Practice Address - Fax:833-685-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty