FOUR RIVERS HEALTHCARE CLINIC (NPI# 1588999007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588999007 |
| Entity Type | Organization |
| Organization Name | FOUR RIVERS HEALTHCARE CLINIC |
| Practice Address |
932 W Idaho Ave Ste 100 Ontario OR 97914-2155 |
| Mailing Address |
640 Sw 4th Ave Ontario OR 97914-2625 |
| Practice Telephone | 5418892244 |
| Practice Fax Number | 5418892626 |
| Mailing Telephone | 5418893510 |
| Mailing Fax Number | 5418893510 |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |
| Authorized Official Name | JODY AILEEN STARK (PRESIDENT) |
| Authorized Official Telephone | 5418892244 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
200550081NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
07904 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
932 W IDAHO AVE STE 100 |
| City | ONTARIO |
| State | OR |
| Zip Code | 97914-2155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316107782 | Stark Medical, PC | Allergy & Immunology | 932 W Idaho Ave Ste 100, Ontario, OR 97914-2155 | 2008-06-10 |
| 1063754208 | Stark Medical Group PC | Allergy & Immunology | 932 W Idaho Ave Ste 100, Ontario, OR 97914-2155 | 2013-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467925420 | The Family Place D/b/a Tfp Services Therapeutic | Case Manager/Care Coordinator | 390 Ne 2nd St., Ontario, OR 97914 | 2019-01-02 |
| 1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
| 1700334117 | Arlene Schwenke | Social Worker | 686 Nw 9th St., Ontario, OR 97914 | 2016-09-14 |
| 1871990408 | Sally Melissa Sluder | Nurse Practitioner | 351 Sw 9th Ave, Ontario, OR 97914 | 2014-11-25 |
| 1932460870 | E Patricia Jeanne Engel | Surgery | 1050 Sw 3rd Ave Ste 2600, Ontario, OR 97914 | 2012-06-07 |
| 1487946521 | Tyler Jepson | Physical Therapist | 1182 Sw 4th Avenue, Ontario, OR 97914 | 2011-05-09 |
| 1255641577 | Cami Lyn Rebmann | Pharmacist | 728 S 4th Ave, Ontario, OR 97914 | 2010-10-20 |
| 1295051126 | Project Dove | Case Manager/Care Coordinator | 915-02 Sw 2nd Ave, Ontario, OR 97914 | 2010-04-16 |
| 1467666024 | Tfp Therapeutic Service, Inc. | Counselor | 390 Ne 2nd Street, Ontario, OR 97914 | 2007-05-10 |
| 1639381569 | Emeritus Corporation | Assisted Living Facility | 1372 Southwest 8th Avenue, Ontario, OR 97914 | 2007-05-04 |
| Find all providers in zip 97914 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023471000 | Mark Berger | Clinical Nurse Specialist | 2327 Sw 4th Ave, Ontario, OR 97914-1851 | 2016-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881887602 | Coehlo & Coehlo, LLC | Clinical Nurse Specialist | 62930 Ob Riley Rd, Suite # 300, Bend, OR 97701-9458 | 2007-08-24 |
| 1407306475 | Asante Physcian Partners | Clinical Nurse Specialist | 520 Sw Ramsey Ave, Ste 101, Grants Pass, OR 97527-5535 | 2016-10-13 |
Please comment or provide details below to improve the information on FOUR RIVERS HEALTHCARE CLINIC.
| 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.