| Adventist Health Columbia Gorge | |
|
1620 E 12th St The Dalles OR 97058 | |
| (541) 296-9151 | |
| (541) 296-9156 |
| Full Name | Adventist Health Columbia Gorge |
|---|---|
| Speciality | Clinic/Center |
| Location | 1620 E 12th St, The Dalles, Oregon |
| Authorized Official Name and Position | Dennis Knox (CORPORATE OFFICER CEO) |
| Authorized Official Contact | 5412967273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventist Health Columbia Gorge 1620 E 12th St Po Box 1520 The Dalles OR 97058 Ph: (541) 296-9151 | Adventist Health Columbia Gorge 1620 E 12th St The Dalles OR 97058 Ph: (541) 296-9151 |
| NPI Number | 1154351336 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Medicare PECOS PAC ID | 3779487251 |
|---|---|
| Medicare Enrollment ID | O20050826000916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154351336 | NPI | - | NPPES |
| 1003624 | Medicaid | WA | |
| 218112 | Medicaid | OR |
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