Stayton Family Practice LLC

NPI #1659524494 in Stayton, Oregon

Provider Information

NPI Number
1659524494
Entity Type
Organization
Organization Name
Stayton Family Practice LLC
Primary Specialty
Family Medicine
Enumeration Date
Oct 24, 2008
Last Updated
Aug 25, 2009

Practice Location

Address
1375 N 10TH AVE
State
Oregon
ZIP Code
97383-2037
Phone
(503) 769-2641

Authorized Official

Name
LANCE B LARGE, MD
Title
OWNER
Phone
(503) 769-2641

Specialties & Taxonomy Codes

Specialty
Family Medicine

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