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Icco Llc
Primary Care Clinic/Center in Eugene, Oregon
NPI 1235672478

Icco Llc is a Primary Care Clinic/Center based in Portland, OR and is specialized in Primary Care. Icco Llc practices in Eugene, OR. The NPI Number for Icco Llc is 1235672478 and holds a License No. (Oregon).

The current practice location address for Icco Llc is 2710 Willamette Street, Eugene, OR and can be reached out via phone at 541-505-7317 and via fax at 541-505-7486. You can also correspond with Icco Llc through the mailing address at PO BOX 4858, PORTLAND, OR - 97208-4858 (mailing address contact number: ).

Location: 2710 Willamette Street, Eugene, OR, 97208-4858
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235672478
Provider Name
Icco Llc
Credential
Provider Entity Type
Organization
Address
2710 Willamette Street, Eugene, OR, 97208-4858
Phone Number
541-505-7317
Fax Number
541-505-7486
Provider Enumeration Date
11/21/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
DP1360 01 OR RR MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
2710 Willamette Street
City
Eugene
State
Oregon
Zip
97405
Phone Number
541-505-7317
Fax Number
541-505-7486
person
Provider Business Mailing Address Details
Address
Po Box 4858
City
Portland
State
Oregon
Zip
97208-4858
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
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Definition
Definition to come...
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