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WHITE OAK MEDICAL CLINIC LLC
NPI 1205305190
Clinic/Center - Primary Care in Roseburg, OR

Active since November 20, 2018
340 NW MEDICAL LOOP, ROSEBURG, OR 97471(541) 464-5907(541) 464-8481 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 22, 2025, Nov 20, 2018 (2 updates tracked since 2018).

About White Oak Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WHITE OAK MEDICAL CLINIC LLC (NPI 1205305190) is a healthcare organization registered as a primary care in Roseburg, Oregon and active in the NPI registry since November 2018. The organization lists Diane Bolduc, President, as its authorized official.

NPPES Registry Identity

NPI1205305190
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameWHITE OAK MEDICAL CLINIC LLC
Location Address340 NW MEDICAL LOOPRoseburg, OR 97471-1645
Mailing Address340 Nw Medical LoopRoseburg, OR 97471-1645 · (541) 464-5907 · Fax (541) 464-8481
Phone(541) 464-5907
Fax(541) 464-8481
Organization SubpartNo
Authorized OfficialDiane BolducPresident · (541) 464-5907
Enumeration DateNovember 20, 2018
Last NPPES UpdateMay 22, 20252 updates tracked since enumeration
NPPES CertifiedMay 21, 2025
✔ NPI 1205305190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
340 NW MEDICAL LOOP, Roseburg, OR 97471
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARIE HEBERT M.D.
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
WHITE OAK MEDICAL CLINIC LLC
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
RACHEL HEBERT FNP
Nurse Practitioner (Family)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 733-8206
ROSEBURG FAMILY MEDICINE
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 677-6599
PACIFIC HEALTHCARE SERVICES, P.C.
Clinic/Center
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
STEVEN MICHAEL PRUDENCIO FNP
Family Medicine
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907
CYNTHIA J KEYS P.A.-C.
Physician Assistant (Medical)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 677-6599
EMMANUELLE HEBERT
Nurse Practitioner (Family)
340 NW MEDICAL LOOP
ROSEBURG, OR 97471
Douglas County (541) 464-5907

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is White Oak Medical Clinic LLC's NPI number?

The NPI number for White Oak Medical Clinic LLC is 1205305190. It was assigned to this organization in the NPPES registry on November 20, 2018.

Where is White Oak Medical Clinic LLC located?

White Oak Medical Clinic LLC is located at 340 NW Medical Loop, Roseburg, OR 97471. The listed phone number is (541) 464-5907.

What is White Oak Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for White Oak Medical Clinic LLC was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.