OrganizationActive
Icco, LLC
NPI 1336725233 · Rural Health Clinic/Center · Cottage Grove, OR
Provider details
- NPI number
- 1336725233
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Erica Hauser, Director
Practice location
1445 Gateway Blvd
Cottage Grove, OR 97424-1224
Phone: (541) 942-7000
Fax: (541) 998-4571
Mailing address
Po Box 4858
Portland, OR 97208-4858
Registry dates
- Enumerated
- 2021-03-22
- Last updated
- 2022-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.