NORTH LAKE CLINIC
NPI 1457745101
Clinic/Center in Christmas Valley, OR

Q: What is Pat Widenoja Fnp's NPI number?

The NPI number for Pat Widenoja Fnp is 1457745101. It was assigned to this organization in the NPPES registry on March 20, 2015. The provider is doing business as North Lake Clinic.

Q: What is Pat Widenoja Fnp's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Pat Widenoja Fnp was last updated on March 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.

Active since March 20, 2015

87520 BAY RD, POB 377, CHRISTMAS VALLEY, OR 97641(541) 576-2343(541) 576-2869 Get Directions Write a Review

NPPES record last updated: March 20, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About North Lake Clinic NPPES

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

NORTH LAKE CLINIC (NPI 1457745101) is a healthcare organization registered as a clinic/center in Christmas Valley, Oregon and active in the NPI registry since March 2015. The organization lists Patricia D Widenoja, Owner, as its authorized official.

NPPES Registry Identity

NPI1457745101

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NamePAT WIDENOJA FNP

Location Address87520 BAY RD, POB 377Christmas Valley, OR 97641-0377

Mailing AddressPob377, 87520 Bay RdChristmas Valley, OR 97641 · (541) 576-2343 · Fax (541) 576-2869

Phone(541) 576-2343

Fax(541) 576-2869

Organization SubpartNo

Authorized OfficialPatricia D WidenojaOwner · (541) 576-2343

Enumeration DateMarch 20, 2015

✔ NPI 1457745101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in OR · 078041667

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

87520 BAY RD, Christmas Valley, OR 97641

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Other Names 1

Doing Business AsNorth Lake Clinic

Other Providers at the Same Location NPPES 7

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

DENNIS M. BRUNEAU PA-C

Physician Assistant