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1108 June St Hood River OR 97031-1513 | |
| (541) 387-6125 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1108 June St, Hood River, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 3390 Portland OR 97208-3390 Ph: () - | 1108 June St Hood River OR 97031-1513 Ph: (541) 387-6125 |
| NPI Number | 1073100095 |
|---|---|
| Provider Enumeration Date | 12/23/2020 |
| Last Update Date | 06/13/2023 |
| Medicare PECOS PAC ID | 7315856010 |
|---|---|
| Medicare Enrollment ID | O20210205002485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073100095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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