| Wallowa Memorial Hospital | |
|
601 Medical Parkway Enterprise OR 97828-1167 | |
| (541) 426-3111 | |
| (541) 426-1901 |
| Full Name | Wallowa Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 601 Medical Parkway, Enterprise, Oregon |
| Authorized Official Name and Position | Joseph Matthew Wanner (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5414265460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wallowa Memorial Hospital 601 Medical Parkway Enterprise OR 97828 Ph: (541) 426-3111 | Wallowa Memorial Hospital 601 Medical Parkway Enterprise OR 97828-1167 Ph: (541) 426-3111 |
| NPI Number | 1447256250 |
|---|---|
| Provider Enumeration Date | 06/27/2005 |
| Last Update Date | 01/31/2023 |
| Medicare PECOS PAC ID | 4183537566 |
|---|---|
| Medicare Enrollment ID | O20031120000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447256250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 140068 (Oregon) | Secondary |
| 261QC0050X | Clinic/center - Critical Access Hospital | 14-0068 (Oregon) | Primary |
| Provider Name | Gary M Zeigler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295772291 PECOS PAC ID: 5890699342 Enrollment ID: I20031125000719 |
| Provider Name | Renee E Grandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356334601 PECOS PAC ID: 2668379652 Enrollment ID: I20031217000791 |
| Provider Name | Scott T Fry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972577195 PECOS PAC ID: 2163491820 Enrollment ID: I20050701000609 |
| Provider Name | Emily A Sheahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609821263 PECOS PAC ID: 1759319783 Enrollment ID: I20050801000809 |
| Provider Name | Kirsten E Caine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295773463 PECOS PAC ID: 0941238646 Enrollment ID: I20050803000447 |
| Provider Name | Elizabeth C Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164456539 PECOS PAC ID: 1557368495 Enrollment ID: I20061107000068 |
| Provider Name | Keith R De Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083829402 PECOS PAC ID: 0941378566 Enrollment ID: I20081009000622 |
| Provider Name | Kenneth D Rose |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588658801 PECOS PAC ID: 5395930200 Enrollment ID: I20101117000296 |
| Provider Name | Traci M Frye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356388094 PECOS PAC ID: 5890962054 Enrollment ID: I20120111000937 |
| Provider Name | Annika Maly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427498328 PECOS PAC ID: 3577889328 Enrollment ID: I20160728002611 |
| Provider Name | Geoffrey Maly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578825022 PECOS PAC ID: 4981834827 Enrollment ID: I20160810000342 |
| Provider Name | Jennifer L Barden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053866632 PECOS PAC ID: 8729366398 Enrollment ID: I20161102001039 |
| Provider Name | Weston Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023429883 PECOS PAC ID: 5597982371 Enrollment ID: I20180920002879 |
| Provider Name | Emily Lauren Knudsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750761284 PECOS PAC ID: 3971819160 Enrollment ID: I20180921002171 |
| Provider Name | Kelsey Eliza Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619397221 PECOS PAC ID: 8123337227 Enrollment ID: I20181026001018 |
| Provider Name | Jennifer Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134679509 PECOS PAC ID: 5799054391 Enrollment ID: I20190802002786 |
| Provider Name | Linda Laverne Keddington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760675953 PECOS PAC ID: 6204923493 Enrollment ID: I20191125000269 |
| Provider Name | Sarah Georgine Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689268260 PECOS PAC ID: 7911315890 Enrollment ID: I20210413002635 |
| Provider Name | Bradley Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235164138 PECOS PAC ID: 8921096363 Enrollment ID: I20210511000820 |
| Provider Name | Katie Weller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275584534 PECOS PAC ID: 4880607977 Enrollment ID: I20210810003998 |
| Provider Name | Nicholas Bennett West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326508631 PECOS PAC ID: 5890038590 Enrollment ID: I20220804001775 |
Winding Waters Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Medical Pkwy, Enterprise, OR 97828 Phone: 541-426-4502 Fax: 541-426-6403 | |
Olive Branch Family Health Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 W North Street, Enterprise, OR 97828 Phone: 541-426-7171 Fax: 541-426-7176 | |
Wallowa Memorial Medical Clinic - Downtown Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 306 W North St, Enterprise, OR 97828 Phone: 541-426-7900 | |
Frontier Family Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 W North St, Enterprise, OR 97828 Phone: 541-426-3797 Fax: 541-426-3798 | |
Open Space Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 758 Nw 1st St, Enterprise, OR 97828 Phone: 541-426-4502 | |
Alder Springs Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Sw 1st St, Suite 104, Enterprise, OR 97828 Phone: 541-426-6070 Fax: 541-426-6079 |