NPIMap

Organization Active NPI

La Clinica del Valle Family Health Care Center Inc.

  • Community/Retail Pharmacy
  • Medford, OR
National Provider Identifier
1003469354
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Practice address
616 Market St
Medford, OR 97504-6126
Phone
(541) 535-6239
Fax
(541) 414-2524
NPI assigned
Jul 16, 2019
Last updated
Sep 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Traci Fossen
Title
Chief Quality Officer
Phone
(541) 512-3912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

616 Market St
Medford, OR 97504-6126

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 535-6239

Other names 2

  • La Clinica Community Pharmacy Other name
  • La Clinica Community Pharmacy-Market Street Other name

National Provider Directory

National Provider Directory
Tax ID family
La Clinica del Valle Family Health Care Center Inc33 organizations share this tax ID, including this one
Part of
La Clinica del Valle Family Health Care Center Inc

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1003469354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239",
            "fax_number": "541-842-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 MARKET ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046126",
            "telephone_number": "541-535-6239",
            "fax_number": "541-414-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.",
        "enumeration_date": "2019-07-16",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "FOSSEN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "541-512-3912"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Clinica Community Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "La Clinica Community Pharmacy-Market Street",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.