Provider Demographics
NPI:1013094002
Name:MCMINNVILLE WOMENS HEALTH CARE PC
Entity Type:Organization
Organization Name:MCMINNVILLE WOMENS HEALTH CARE PC
Other - Org Name:WOMENS HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-435-2020
Mailing Address - Street 1:2700 SE STRATUS AVENUE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128
Mailing Address - Country:US
Mailing Address - Phone:503-435-2020
Mailing Address - Fax:503-435-1838
Practice Address - Street 1:2700 SE STRATUS AVENUE
Practice Address - Street 2:SUITE 405
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-435-2020
Practice Address - Fax:503-435-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR170099Medicaid
OR170099Medicaid