Provider Demographics
NPI:1013947498
Name:YACHATS COMMUNITY HEALTH CLINIC
Entity Type:Organization
Organization Name:YACHATS COMMUNITY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:ZEIER
Authorized Official - Suffix:
Authorized Official - Credentials:CFPN
Authorized Official - Phone:541-547-3301
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:YACHATS
Mailing Address - State:OR
Mailing Address - Zip Code:97498-0271
Mailing Address - Country:US
Mailing Address - Phone:541-547-3301
Mailing Address - Fax:541-547-3302
Practice Address - Street 1:114 HIGHWAY 101 NORTH
Practice Address - Street 2:
Practice Address - City:YACHATS
Practice Address - State:OR
Practice Address - Zip Code:97498-0271
Practice Address - Country:US
Practice Address - Phone:541-547-3301
Practice Address - Fax:541-547-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227597Medicaid
OR227597Medicaid
383845Medicare ID - Type UnspecifiedRIVERBEND