| Columbia River Health | |
|
450 Tatone Street Boardman OR 97818 | |
| (541) 481-7212 | |
| (541) 481-2020 |
| Full Name | Columbia River Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 450 Tatone Street, Boardman, Oregon |
| Authorized Official Name and Position | Sanjuanita Olivas (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 5414817212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia River Health Po Box 397 Boardman OR 97818 Ph: (541) 481-7212 | Columbia River Health 450 Tatone Street Boardman OR 97818 Ph: (541) 481-7212 |
| NPI Number | 1710084140 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 06/28/2021 |
| Medicare PECOS PAC ID | 8527026087 |
|---|---|
| Medicare Enrollment ID | O20041230000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710084140 | NPI | - | NPPES |
| 276286 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |