Organization · Type 2 NPI
Icco, LLC
Rural Health Clinic/Center · Dallas, OR
NPI number
1619558640
Active
Practice location
186 W Ellendale Ave
Dallas, OR 97338-1408
Fax (971) 900-4977
Mailing address
PO Box 4858
Portland, OR 97208-4858
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Rural Health Clinic/Center Primary | 261QR1300X | None listed |
Rural Health Clinic/Center: Definition to come...
Another provider at this address
Other rural health clinic/center providers in Dallas
About NPI 1619558640
Icco, LLC's National Provider Identifier is 1619558640, issued on Apr 20, 2021. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Dallas, OR. The record was last updated on Jun 29, 2022.