NPIMap

Organization Active NPI

Canby Healthcare Clinic LLC

  • Primary Care Clinic/Center
  • Canby, OR
National Provider Identifier
1083915508
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
085074804 Issued in OR
Legal business name
CANBY HEALTHCARE CLINIC LLC
Practice address
703 SE 1St Ave
Canby, OR 97013-3849
Phone
(503) 266-7686
Fax
(503) 266-7382
NPI assigned
Nov 15, 2010
Last updated
Nov 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Karen Elizabeth Shaw, ANPNPI 1720278633
Title
Staff Adult Nurse Practitioner
Phone
(503) 266-7686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 085074804 OR Primary

Addresses

Primary practice location

703 SE 1St Ave
Canby, OR 97013-3849

Mailing address

18320 S Walker Rd
Oregon City, OR 97045-9326
Phone (503) 631-3420

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1083915508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18320 S WALKER RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459326",
            "telephone_number": "503-631-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 SE 1ST AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133849",
            "telephone_number": "503-266-7686",
            "fax_number": "503-266-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANBY HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "STAFF ADULT NURSE PRACTITIONER",
        "authorized_official_telephone_number": "503-266-7686",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "085074804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.