NPI 1104490887

Icco, LLC

Organisation Rural Health Clinic/Center Lebanon, OR

Practice location

Address: 3400 Cooperative Way, Lebanon, OR 97355-4063
Phone: (541) 666-3305
Fax: (541) 666-3306
Mailing address: PO Box 4858, Portland, OR 97208-4858

Authorised official

Name: Erica Hauser
Title: Cfo
Phone: (312) 590-5372

Registered specialties

Rural Health Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QR1300X

Other Clinic/Center providers in Oregon →

Registry record

NPI: 1104490887
Entity type: Organization
NPI issued: 17 May 2021
Record last updated: 20 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.