Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

White Oak Medical Clinic LLC

Organization Family Medicine Physician · NPI 1205305190

White Oak Medical Clinic LLC is a Family Medicine Physician in Roseburg, Oregon. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

340 NW Medical Loop
Roseburg, OR 97471-1645
Phone: (541) 464-5907
Fax: (541) 464-8481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Family Medicine Physician Taxonomy 207Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) Taxonomy 261QM0801X
Family Nurse Practitioner Taxonomy 363LF0000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1205305190
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Bolduc — President · (541) 464-5907
NPI enumeratedNovember 20, 2018
Last updated in NPPESMay 22, 2025
Certification dateMay 21, 2025
Mailing address340 Nw Medical Loop, Roseburg, OR 97471-1645

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