Provider Demographics
NPI:1942548433
Name:YOUR CARE LLC
Entity Type:Organization
Organization Name:YOUR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WATTENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-548-2899
Mailing Address - Street 1:PO BOX 1870
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-0541
Mailing Address - Country:US
Mailing Address - Phone:541-548-2899
Mailing Address - Fax:
Practice Address - Street 1:3818 SW 21ST PL
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-6801
Practice Address - Country:US
Practice Address - Phone:541-548-2899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1546513-1261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care