Provider Demographics
NPI:1134746589
Name:REDMOND VETERINARY CLINIC PC
Entity type:Organization
Organization Name:REDMOND VETERINARY CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:541-548-1048
Mailing Address - Street 1:1785 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1204
Mailing Address - Country:US
Mailing Address - Phone:541-548-1048
Mailing Address - Fax:541-548-2323
Practice Address - Street 1:1785 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1204
Practice Address - Country:US
Practice Address - Phone:541-548-1048
Practice Address - Fax:541-548-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center