| Providence Heart Clinic Hood River | |
|
917 11th St Suite 200 Hood River OR 97031-1578 | |
| (541) 387-8945 | |
| Not Available |
| Full Name | Providence Heart Clinic Hood River |
|---|---|
| Speciality | Clinic/center |
| Location | 917 11th St, Hood River, Oregon |
| Authorized Official Name and Position | Keenan B Freeman (CFO) |
| Authorized Official Contact | 5038936524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Heart Clinic Hood River Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Heart Clinic Hood River 917 11th St Suite 200 Hood River OR 97031-1578 Ph: (541) 387-8945 |
| NPI Number | 1225321581 |
|---|---|
| Provider Enumeration Date | 05/19/2011 |
| Last Update Date | 09/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225321581 | NPI | - | NPPES |
| 500639395 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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