THE CORVALLIS CLINIC, P.C. (NPI# 1447391727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447391727 |
| Entity Type | Organization |
| Organization Name | THE CORVALLIS CLINIC, P.C. |
| Practice Address |
3680 Nw Samaritan Dr Corvallis OR 97330-3737 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 5417541150 |
| Mailing Telephone | 8586252990 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2012-10-16 |
| Authorized Official Name | MR. KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | MD23056 | OR | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | THE CORVALLIS CLINIC, P.C. | 444 Nw Elks Dr, Corvallis, OR 97330 |
| Street Address |
3680 NW SAMARITAN DR |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-3737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508852252 | Patricia Shannon Hopson | Internal Medicine | 3680 Nw Samaritan Dr, Corvallis, OR 97330 | 2005-09-27 |
| 1568007649 | Miriam Geneva Powell | Specialist/Technologist, Other | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2019-11-12 |
| 1043853948 | Elise Noel Bascom | Psychologist | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2019-10-23 |
| 1881252252 | Jennifer Marie Giles | Surgery | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2019-05-31 |
| 1316503774 | Naomi Elizabeth Shantz | Nurse Practitioner | 3680 Nw Samaritan Dr, Corvallis, OR 97330 | 2019-05-11 |
| 1134613110 | Maddison Marie Greaves | Dietitian, Registered | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2018-06-21 |
| 1831631522 | Joshua Bergh | Physician Assistant | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2016-11-10 |
| 1063961373 | Elisabeth Romatz Mahmud | Registered Nurse | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2016-09-27 |
| 1689127045 | Nicolette Rosendahl | Neuromusculoskeletal Medicine & OMM | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2016-08-02 |
| 1003271727 | Laura Luczkiw | Dietitian, Registered | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2015-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754912 | Miya Claborn | Counselor | 4495 Se Hwy 20, Corvallis, OR 97330 | 2020-06-09 |
| 1548889017 | Greydi Olvera | Counselor | Childrens Farm Home 4455 Ne Hwy 20, Corvallius, OR 97330 | 2020-04-14 |
| 1053953992 | Andie Marie Gaipo | Counselor | 4455 Ne Hwy 20 - Children's Farm Home, Corvallis, OR 97330 | 2019-10-11 |
| 1740847177 | Stephen Jack Eccles | Behavior Technician | Trillium Children's Farm Home, 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-05-21 |
| 1750944815 | Tiffany Rene Flinchpaugh | Counselor | Children's Farm Home 4455 Hwy 20, Corvallis, OR 97330 | 2019-04-15 |
| 1679035455 | Isaiah Mile Cassidy | Counselor | Children's Farm Home-4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-04-02 |
| 1982168399 | Haylee Cramblit | Counselor | Children's Farm Home 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-01-30 |
| 1457835365 | Ashley Alyn Couch | Counselor | 4455 Hwy 20 Corvallis 97330, Corvallis, OR 97330 | 2018-09-18 |
| 1104318898 | Megan Gerding | Technician, Other | 996 Nw Circle Blvd Suite 103, Corvallis, OR 97330 | 2018-05-30 |
| 1700377108 | Pacific Hearing Services | Audiologist | 975 Nw Spruce Ave, Suite #101, Corvallis, OR 97330 | 2018-05-22 |
| Find all providers in zip 97330 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154931814 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 6910 Se Milwaukie Ave, Portland, OR 97202-5717 | 2020-08-06 |
| 1962012955 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 111 A Ave, Lake Oswego, OR 97034-3116 | 2020-08-04 |
| 1366052367 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 25600 Sw Argyle Ave Ste B, Wilsonville, OR 97070-4701 | 2020-08-04 |
| 1659981652 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 2711 Ne Town Center Dr Ste 2, Hillsboro, OR 97006-8951 | 2020-08-04 |
| 1902416175 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 8179 N Lombard St, Portland, OR 97203-3130 | 2020-08-03 |
| 1144830365 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 945 Nw Lovejoy St, Portland, OR 97209-3475 | 2020-08-03 |
| 1174133300 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 7855 Sw Capitol Hwy, Portland, OR 97219-2465 | 2020-08-03 |
| 1386254514 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 3872 N Mississippi Ave, Portland, OR 97227-1161 | 2020-08-03 |
| 1194335364 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 2490 Willamette St Ste 4, Eugene, OR 97405-7211 | 2020-08-03 |
| 1265042436 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 11355 Sw Scholls Ferry Rd, Beaverton, OR 97008-7167 | 2020-08-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.