NPIMap

Organization Active NPI

West Linn Family Health Center

  • Family Medicine Physician
  • West Linn, OR
National Provider Identifier
1114959707
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD16003 Issued in OR
Legal business name
WEST LINN FAMILY HEALTH CENTER
Practice address
18380 Willamette Dr
Suite 202
West Linn, OR 97068-1200
Phone
(503) 635-8384
Fax
(503) 636-6475
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Mary Edwards
Title
Office Manager
Phone
(503) 635-8384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD16003 OR Primary

Addresses

Primary practice location

18380 Willamette Dr
Suite 202
West Linn, OR 97068-1200

Mailing address

18380 Willamette Dr
Suite 202
West Linn, OR 97068-1200
Phone (503) 635-8384

Other identifiers 1

IdentifierTypeStateIssuer
230459MedicaidOR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0622499West Linn Family Health Ctr Lab18380 Willamette Ste 202, West Linn, OR 97068Provider-performed microscopyDec 31, 2027

National Provider Directory

National Provider Directory

Locations

18380 Willamette Dr
Ste 202
West Linn, OR 97068
Phone (503) 635-8384

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114959707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18380 WILLAMETTE DR",
            "address_2": "SUITE 202",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681200",
            "telephone_number": "503-635-8384",
            "fax_number": "503-636-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18380 WILLAMETTE DR",
            "address_2": "SUITE 202",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681200",
            "telephone_number": "503-635-8384",
            "fax_number": "503-636-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST LINN FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-635-8384",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD16003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230459",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.