Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health &

NPI 1104164359 - Clinic/Center - 261QC1500X

NPI Details
NPI 1104164359
Enumeration Date 01/23/2013
Last Updated 01/23/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name MARK MARK
Position GENERAL MANAGER
Phone (503) 879-2236
Fax
Practice Location
9605 GRAND RONDE RD
GRAND RONDE OR, 97347-9712, US
Phone (503) 879-2236
Fax
Business Location
PO BOX 338
GRAND RONDE OR, 97347-0338, US
Phone (503) 879-2236
Fax
Toxanomy
Taxonomy Code 261QC1500X
License State Oregon
License Number 201070009CNS
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According to our database, Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & NPI is 1104164359, taxonomy code is 261QC1500X and license number is 201070009CNS, license state is located at Oregon. Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & physically located at 9605 Grand Ronde Rd, Grand Ronde OR, 97347-9712. NPI Number 1033115704 has the healthcare provider type.

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1104164359 NPI number is provided on an as is basis without warranty of any kind. 1104164359 is maintained by the National Plan & Provider Enumeration System. The contents of Confederated Tribes Of Grand Ronde Community Of Oregon Dba Gr Health & are for informational purposes only.