Provider Demographics
NPI:1619707056
Name:COMPASS MEDICAL CLINIC LLC
Entity type:Organization
Organization Name:COMPASS MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:503-623-1200
Mailing Address - Street 1:607 SE JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-2025
Mailing Address - Country:US
Mailing Address - Phone:503-623-1200
Mailing Address - Fax:503-623-1414
Practice Address - Street 1:607 SE JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2025
Practice Address - Country:US
Practice Address - Phone:503-623-1200
Practice Address - Fax:503-623-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty