Four Rivers Healthcare Clinic

NPI #1588999007 in Ontario, Oregon

Provider Information

NPI Number: 1588999007
Entity Type: Organization
Organization Name: Four Rivers Healthcare Clinic
Primary Specialty: Clinical Nurse Specialist - Family Health
Enumeration Date: Oct 16, 2009
Last Updated: Oct 16, 2009

Practice Location

Address: 932 W IDAHO AVE STE 100
City: Ontario
State: Oregon
ZIP Code: 97914-2155
Phone: (541) 889-2244

Authorized Official

Name: JODY AILEEN STARK, FNP
Title: PRESIDENT
Phone: (541) 889-2244

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X
Clinical Nurse Specialist - Family Health — Family Health	364SF0001X	Primary

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