South Coast Healthcare Llc

Specialty details in registry · Gold Beach, OR

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At a glance

29641 Ellensburg Ave, Gold Beach, OR 97444-8701

NPPES record updated Oct 27, 2020. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

29641 Ellensburg Ave
Gold Beach, OR 97444-8701
Professional details: NPI, taxonomy & registry record
NPI1134740152
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
261QP2300X
Enumeration date
Apr 30, 2020
Record updated
Oct 27, 2020
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

261QP2300X · Primary

Family Nurse Practitioner

363LF0000X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

29641 Ellensburg Ave
Gold Beach, OR 97444-8701
Phone
(541) 698-8080
Mailing address
29641 ELLENSBURG AVE

GOLD BEACH, OR 974448701
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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