Full Name | |
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Speciality | Clinic/Center |
Location | 1890 7th St., Umatilla, Oregon |
Authorized Official Name and Position | Jessica M Reagan (REVENUE CYCLE DIRECTOR) |
Authorized Official Contact | 5419666136 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1517 Pendleton OR 97801-0410 Ph: (877) 708-1119 | 1890 7th St. Umatilla OR 97882 Ph: (541) 567-6434 |
NPI Number | 1770183063 |
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Provider Enumeration Date | 10/27/2020 |
Last Update Date | 08/30/2021 |
Medicare PECOS PAC ID | 8325941446 |
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Medicare Enrollment ID | O20210105001101 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770183063 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |