Wvp Medical Group, LLC

NPI #1164780060 in Dallas, Oregon

Provider Information

NPI Number: 1164780060
Entity Type: Organization
Organization Name: Wvp Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WVP MEDICAL GROUP
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Apr 27, 2012
Last Updated: Apr 17, 2018

Practice Location

Address: 1000 SE UGLOW AVE
City: Dallas
State: Oregon
ZIP Code: 97338-2645
Phone: (503) 623-8376

Authorized Official

Name: KATHY DEATON
Title: PRACTICE ADMINISTRATOR
Phone: (503) 623-8376

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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