CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON DBA GR HEALTH & (NPI# 1104164359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104164359 |
| Entity Type | Organization |
| Organization Name | CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON DBA GR HEALTH & |
| Practice Address |
9605 Grand Ronde Rd Grand Ronde OR 97347-9712 |
| Mailing Address |
Po Box 338 Grand Ronde OR 97347-0338 |
| Practice Telephone | 5038792236 |
| Mailing Telephone | 5038792236 |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2013-01-23 |
| Authorized Official Name | MR. MARK JOHNSTON (GENERAL MANAGER) |
| Authorized Official Telephone | 5038794638 |
| Is Organization Subpart | Y |
| Parent Organization Name | CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
201070009CNS | OR | Ambulatory Health Care Facilities |
| Street Address |
9605 GRAND RONDE RD |
| City | GRAND RONDE |
| State | OR |
| Zip Code | 97347-9712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932180734 | Lance Gregory Loberg | Family Medicine | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2005-11-08 |
| 1003286840 | Albert Martineau | Counselor | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2015-10-06 |
| 1417390634 | Andrew R Canning | Student in an Organized Health Care Education/Training Program | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2013-04-08 |
| 1508111931 | Capitol Physical Therapy, Inc | Physical Therapist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2012-07-23 |
| 1477845352 | Jeanette Marie Kaschmitter | Counselor | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2011-05-10 |
| 1366765687 | George Ryan Davis | Dentist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2010-03-02 |
| 1467692350 | Ashley Rose Nunley | Chiropractor | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2009-03-05 |
| 1477711802 | Confederated Tribes of The Grand Ronde Community of Oregon | Pharmacy | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2008-06-02 |
| 1881875375 | Lincoln Wright | Pharmacist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-11-26 |
| 1417144387 | Myron T Peng | Dentist | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023325859 | Linda 'lynn' Michelle House | Licensed Practical Nurse | 7650 Birch Street, Grand Ronde, OR 97347-0024 | 2010-08-31 |
| 1689700213 | Angela R Vargas | Counselor | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-02-26 |
| 1326513367 | Confederated Tribes of Grand Ronde Community of Oregon | Radiology | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2018-10-05 |
| 1922554542 | Terri Knowles | Optometrist | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2016-09-01 |
| 1093073439 | Nicole Marie Estrada | Counselor | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2012-04-23 |
| 1881970069 | Sarah J Ross | Speech-Language Pathologist | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2011-11-01 |
| 1073709499 | Erin Margaret Lange | Dentist | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2007-09-19 |
| 1477720365 | Martie M Coblentz | Contractor | 27725 Jahn Rd, Grand Ronde, OR 97347-9735 | 2008-05-11 |
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1346850500 | Opportunity Connections, Inc. | Clinic/Center | 1102 12th St, Hood River, OR 97031-1602 | 2020-08-03 |
| 1750827184 | Elizabeth Villagrana | Clinic/Center | 32753 E Delaney St, Coburg, OR 97408-9265 | 2017-01-09 |
| 1811339666 | Oregon Health & Science University | Clinic/Center | 2952 Ne 34th Ave, Portland, OR 97212-2705 | 2013-07-22 |
| 1316268220 | Ruthie Faye Berrell | Clinic/Center | 1640 G Street, Springfield, OR 97477 | 2010-06-15 |
| 1588981096 | Joan Jackson Cavan | Clinic/Center | 86595 N Modesto Dr, Eugene, OR 97402-9045 | 2010-04-23 |
| 1639316193 | La Pine Community Health Center | Clinic/Center | 51600 Huntington Road, Suite C, La Pine, OR 97739-0001 | 2009-01-20 |
| 1376546291 | Willamette Family, Inc | Clinic/Center | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2005-05-24 |
| 1124534185 | Columbiacare Services Inc | Clinic/Center | 2345 Marion St, North Bend, OR 97459-2637 | 2017-12-28 |
| 1457897548 | Lukedorf | Clinic/Center | 8915 Sw Center St, Tigard, OR 97223-6307 | 2017-01-12 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RONDE |
| Zip Code | 97347 |
Please comment or provide details below to improve the information on CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON DBA GR HEALTH &.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.