CORVALLIS CLINIC PC (NPI# 1649227265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649227265 |
| Entity Type | Organization |
| Organization Name | CORVALLIS CLINIC PC |
| Practice Address |
444 Nw Elks Dr Corvallis OR 97330-3745 |
| Practice Telephone | 5417541150 |
| Mailing Telephone | 5417541150 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2018-12-03 |
| Authorized Official Name | MR. EDWARD KELLY (CEO) |
| Authorized Official Telephone | 5417541374 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 043158 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881850386 | Corvallis Clinic PC | Clinic/Center | 601 Nw Elks Drive, Corvallis, OR 97330-3781 | 2008-08-04 |
| 1699921296 | Corvallis Clinic PC | Clinical Medical Laboratory | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2008-08-14 |
| 1730345596 | Corvallis Clinic PC | Clinic/Center | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2008-07-31 |
| Street Address |
444 NW ELKS DR |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-3745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790952 | Shelly R Svoboda | Psychiatry & Neurology | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2005-06-16 |
| 1770098659 | Heather Lauren Herman | Nurse Practitioner | 444 Nw Elks Dr, Corvallis, OR 97330 | 2017-12-13 |
| 1033642020 | Beth Anne Rathbun | Physician Assistant | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2017-04-06 |
| 1649678434 | Diane Wendel Habel | Social Worker | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2014-12-11 |
| 1912317751 | Caitlin Deede | Registered Nurse | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2014-05-01 |
| 1851722706 | Nelson Joseph Binggeli | Psychologist | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2013-12-03 |
| 1396087110 | Bryce Andrew Allio | Urology | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2013-03-19 |
| 1699040311 | Kristen Workman | Specialist/Technologist, Other | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2012-03-13 |
| 1295013613 | Gregory Allen Richard | Ophthalmology | 444 Nw Elks Dr, Corvallis, OR 97330 | 2011-08-02 |
| 1083904304 | Keith Ryan Wells | Internal Medicine | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2011-04-08 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1164736393 | Vertebrata Chiropractic, PC | Clinic/Center | 107 Sw 2nd St, Corvallis, OR 97333-4715 | 2010-07-29 |
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| 1922583616 | Wvp Medical Group, LLC | Clinic/Center | 2995 Ryan Dr Se Ste 200, Salem, OR 97301-5157 | 2018-09-27 |
| 1588153076 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3060 Se Hawthorne Blvd, Portland, OR 97214-4121 | 2018-05-09 |
| 1942718457 | Mid-columbia Medical Center | Clinic/Center | 1815 E 19th St Ste 1, The Dalles, OR 97058-3385 | 2018-01-18 |
| 1255844908 | Affordable Health Care & Chiropractic Inc | Clinic/Center | 2130 Se 96th Ave, Portland, OR 97216-2603 | 2017-11-15 |
| 1710402532 | Edge Medical Services Inc | Clinic/Center | 19800 Village Office Ct Ste 15, Bend, OR 97702-1872 | 2017-08-14 |
| 1699167239 | Community Wellness Center | Clinic/Center | 1995 8th Ave, West Linn, OR 97068-4604 | 2015-02-19 |
| 1730518754 | Rebecca Berzow Nd | Clinic/Center | 15455 Nw Greenbrier Pkwy Ste 100, Beaverton, OR 97006-7357 | 2013-11-12 |
| 1659605707 | University Professional Services | Clinic/Center | 2858 Eberlein Ave, Klamath Falls, OR 97603-4402 | 2009-09-22 |
| 1770769424 | Adapt Training | Clinic/Center | 9923 Sw Arctic Dr, Beaverton, OR 97005-4194 | 2008-01-11 |
| Find all providers with the same taxonomy | ||||
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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.