CORVALLIS CLINIC PC (NPI# 1730345596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730345596 |
| Entity Type | Organization |
| Organization Name | CORVALLIS CLINIC PC |
| Practice Address |
444 Nw Elks Dr Corvallis OR 97330-3745 |
| Practice Telephone | 5417541150 |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2017-02-08 |
| Authorized Official Name | MR. DOUGLAS R BOURDO (CFO) |
| Authorized Official Telephone | 5417541374 |
| Is Organization Subpart | Y |
| Parent Organization Name | CORVALLIS CLINIC PC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
071549 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 043158 | 05 | |
| OR | 299481 | 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 |
| 1649227265 | Corvallis Clinic PC | Technician/Technologist | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2006-05-28 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689800666 | Bsm Surgery Center LLC | Clinic/Center | 1128 Ne Second Street, Suite 104, Corvallis, OR 97330-6293 | 2009-06-04 |
| 1881850386 | Corvallis Clinic PC | Clinic/Center | 601 Nw Elks Drive, Corvallis, OR 97330-3781 | 2008-08-04 |
| 1649327008 | Samaritan Endoscopy LLC | Clinic/Center | 3509 Nw Samaritan Drive, Suite 201, Corvallis, OR 97330-3766 | 2007-01-05 |
| 1457735615 | Coastline Corvallis Clinic LLC | Clinic/Center | 1829 Nw Kings Blvd, Corvallis, OR 97330-1907 | 2015-07-16 |
| 1164829412 | Nw Surgical Center | Clinic/Center | 545 Sw 2nd St, Corvallis, OR 97333-4466 | 2014-12-02 |
| 1801210802 | Nw Surgical Center LLC | Clinic/Center | 545 Sw 2nd St, Corvallis, OR 97333-4466 | 2014-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457826125 | Central Oregon Surgical Institute, LLC | Clinic/Center | 1550 Ne 27th St Ste 110, Bend, OR 97701-7728 | 2018-10-09 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1962920751 | West End Surgical, LLC | Clinic/Center | 9405 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-09-01 |
| 1588181275 | Chase Gardens Surgery Center LLC | Clinic/Center | 360 S Garden Way Ste 100, Eugene, OR 97401-8173 | 2017-08-24 |
| 1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
| 1679939318 | Crater Lake Surgery Center LLC | Clinic/Center | 833 Bennett Ave, Medford, OR 97504-6715 | 2016-01-11 |
| 1902287469 | Gateway Dental Surgery Center | Clinic/Center | 10535 Ne Glisan St Ste 101, Portland, OR 97220-4095 | 2015-06-10 |
| 1760861835 | Central Oregon Surgery Center LLC | Clinic/Center | 1835 Nw Pence Ln Ste 100, Bend, OR 97703-1551 | 2015-05-22 |
| 1972902286 | Oregon Specialists Surgery Center LLC | Clinic/Center | 2785 River Rd S, Salem, OR 97302-5883 | 2014-08-22 |
| 1649612698 | Willamette Procedure Center PC | Clinic/Center | 2020 8th Ave Ste 212, West Linn, OR 97068-4657 | 2013-07-18 |
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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.