Provider Demographics
NPI:1588919229
Name:WILLAMETTE COMMUNITY HEALTH SOLUTIONS
Entity type:Organization
Organization Name:WILLAMETTE COMMUNITY HEALTH SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOESHANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-228-3001
Mailing Address - Street 1:2650 SUZANNE WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7319
Mailing Address - Country:US
Mailing Address - Phone:541-228-3008
Mailing Address - Fax:541-228-3180
Practice Address - Street 1:200 N MONROE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4243
Practice Address - Country:US
Practice Address - Phone:541-228-3008
Practice Address - Fax:541-228-3180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty