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LEGACY CLINIC WOODBURN
NPI 1821260860
Non-Pharmacy Dispensing Site in Woodburn, OR

Active since March 31, 2008
1002 N BOONES FERRY RD, WOODBURN, OR 97071(503) 981-9526 Get Directions Write a Review

NPPES record last updated: October 22, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Legacy Clinic Woodburn NPPES

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

LEGACY CLINIC WOODBURN (NPI 1821260860) is a healthcare organization registered as a non-pharmacy dispensing site in Woodburn, Oregon and active in the NPI registry since March 2008. The organization lists Kenny Heine, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1821260860
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameLEGACY CLINIC WOODBURN
Location Address1002 N BOONES FERRY RDWoodburn, OR 97071-9602
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(503) 981-9526
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineDirector Of Operations · (858) 625-2990
Enumeration DateMarch 31, 2008
Last NPPES UpdateOctober 22, 2012
✔ NPI 1821260860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in OR · MD19203
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
1002 N BOONES FERRY RD, Woodburn, OR 97071
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Other Providers at the Same Location NPPES 6

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

DR. JENNA MARIE DONALDSON MD
Family Medicine
1002 N BOONES FERRY RD
WOODBURN, OR 97071
Marion County (503) 981-9526
KATHERINE DESIO-SCOTT LCSW
Social Worker (Clinical)
1002 N BOONES FERRY RD
WOODBURN, OR 97071
Marion County (503) 981-9526
BRIAN MATTHEW BEDOLLA MD
Family Medicine
1002 N BOONES FERRY RD
WOODBURN, OR 97071
Marion County (503) 981-9526
RICARDO SANCHEZ
Social Worker (Clinical)
1002 N BOONES FERRY RD
WOODBURN, OR 97071
Marion County (503) 981-9526
LLOYD TETSUO MORITA MD
Internal Medicine
1002 N BOONES FERRY RD
WOODBURN, OR 97071
Marion County (503) 981-9526
CHERYL ANN GOODRICH ACNP
Nurse Practitioner (Adult Health)
1002 N BOONES FERRY RD
WOODBURN, OR 97071
Marion County (503) 981-9526

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 Legacy Clinic Woodburn's NPI number?

The NPI number for Legacy Clinic Woodburn is 1821260860. It was assigned to this organization in the NPPES registry on March 31, 2008.

Where is Legacy Clinic Woodburn located?

Legacy Clinic Woodburn is located at 1002 N Boones Ferry Rd, Woodburn, OR 97071. The listed phone number is (503) 981-9526.

What is Legacy Clinic Woodburn's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Legacy Clinic Woodburn was last updated on October 22, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.