| Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & | |
|
9605 Grand Ronde Rd Grand Ronde OR 97347-9712 | |
| (503) 879-2236 | |
| Not Available |
| Full Name | Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 9605 Grand Ronde Rd, Grand Ronde, Oregon |
| Authorized Official Name and Position | Mark Johnston (GENERAL MANAGER) |
| Authorized Official Contact | 5038794638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & Po Box 338 Grand Ronde OR 97347-0338 Ph: (503) 879-2236 | Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & 9605 Grand Ronde Rd Grand Ronde OR 97347-9712 Ph: (503) 879-2236 |
| NPI Number | 1104164359 |
|---|---|
| Provider Enumeration Date | 01/23/2013 |
| Last Update Date | 01/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104164359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 201070009CNS (Oregon) | Primary |