| Pendleton Family Practice And Sports Medicine Llc | |
|
202 Se Dorion Ave Pendleton OR 97801-2576 | |
| (541) 966-8384 | |
| (541) 966-8387 |
| Full Name | Pendleton Family Practice And Sports Medicine Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 202 Se Dorion Ave, Pendleton, Oregon |
| Authorized Official Name and Position | Darla Linker (OFFICE MANAGER) |
| Authorized Official Contact | 5419668384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pendleton Family Practice And Sports Medicine Llc 202 Se Dorion Ave Pendleton OR 97801-2576 Ph: (541) 966-8384 | Pendleton Family Practice And Sports Medicine Llc 202 Se Dorion Ave Pendleton OR 97801-2576 Ph: (541) 966-8384 |
| NPI Number | 1225538796 |
|---|---|
| Provider Enumeration Date | 02/20/2018 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225538796 | NPI | - | NPPES |
| 150117 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DO20295 (Oregon) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | DO20295 (Oregon) | Primary |
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