Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 1890 7th St, Umatilla, Oregon |
Authorized Official Name and Position | Derek Ted Earl (MEDICAL DIRECTOR) |
Authorized Official Contact | 5415676434 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
600 Nw 11th St Ste E15 Hermiston OR 97838-8602 Ph: (541) 567-6434 | 1890 7th St Umatilla OR 97882-9826 Ph: (541) 567-6434 |
NPI Number | 1437967361 |
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Provider Enumeration Date | 12/23/2024 |
Last Update Date | 01/09/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437967361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |