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551 Lone Pine Blvd Ste 200b The Dalles OR 97058-9404 | |
(541) 298-5563 | |
(541) 298-7746 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 551 Lone Pine Blvd Ste 200b, The Dalles, Oregon |
Authorized Official Name and Position | Tasha L Sandoval (CORPORATE OFFICER CEO) |
Authorized Official Contact | 5419805635 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1520 The Dalles OR 97058-8003 Ph: () - | 551 Lone Pine Blvd Ste 200b The Dalles OR 97058-9404 Ph: (541) 298-5563 |
NPI Number | 1942718457 |
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Provider Enumeration Date | 01/18/2018 |
Last Update Date | 09/25/2023 |
Identifier | Type | State | Issuer |
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1942718457 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Mid-columbia Health Service, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1700 E 19th St, The Dalles, OR 97058 Phone: 541-296-7760 Fax: 541-296-7619 | |
Columbia River Medical Clinic, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1615 E 12th St, Suite 100, The Dalles, OR 97058 Phone: 541-296-1919 Fax: 541-296-2253 |