Provider Demographics
NPI:1245328368
Name:WESTERN YAMHILL MEDICAL CENTER LLC
Entity type:Organization
Organization Name:WESTERN YAMHILL MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUTTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-843-4071
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:OR
Mailing Address - Zip Code:97378-0219
Mailing Address - Country:US
Mailing Address - Phone:503-843-4071
Mailing Address - Fax:503-843-4070
Practice Address - Street 1:950 SE SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:OR
Practice Address - Zip Code:97378-1913
Practice Address - Country:US
Practice Address - Phone:503-843-4071
Practice Address - Fax:503-843-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty