OrganizationActive
Icco, LLC
NPI 1104490887 · Rural Health Clinic/Center · Lebanon, OR
Provider details
- NPI number
- 1104490887
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Erica Hauser, Cfo
Practice location
3400 Cooperative Way
Lebanon, OR 97355-4063
Phone: (541) 666-3305
Fax: (541) 666-3306
Mailing address
Po Box 4858
Portland, OR 97208-4858
Registry dates
- Enumerated
- 2021-05-17
- Last updated
- 2022-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.