MID-COLUMBIA MEDICAL CENTER (NPI# 1154351336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154351336 |
| Entity Type | Organization |
| Organization Name | MID-COLUMBIA MEDICAL CENTER |
| Other Organization Name | MCMC FAMILY MEDICINE |
| Practice Address |
1620 E 12th St The Dalles OR 97058 |
| Mailing Address |
1620 E 12th St Po Box 1520 The Dalles OR 97058 |
| Practice Telephone | 5412969151 |
| Practice Fax Number | 5412969156 |
| Mailing Telephone | 5412969151 |
| Mailing Fax Number | 5412969156 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2017-09-27 |
| Authorized Official Name | CHELSEA TREHARNE (CORPORATE COMPLIANCE OFFICER) |
| Authorized Official Telephone | 5415067620 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1003624 | 05 | |
| OR | 218112 | 05 |
| Other Name | Type Code |
|---|---|
| MCMC FAMILY MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942718457 | Mid-columbia Medical Center | Clinic/Center | 1815 E 19th St Ste 1, The Dalles, OR 97058-3385 | 2018-01-18 |
| 1154869659 | Mid-columbia Medical Center | Podiatrist | 33 Nichols Pkwy, Hood River, OR 97031-3121 | 2017-02-03 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1871833772 | Mid-columbia Medical Center | Obstetrics & Gynecology | 1810 E 19th St Ste 209, The Dalles, OR 97058-3388 | 2013-03-01 |
| 1548525801 | Mid-columbia Medical Center | Dermatology | 1935 E 19th St Ste 110, The Dalles, OR 97058-3392 | 2012-07-11 |
| 1992094817 | Mid-columbia Medical Center | Clinic/Center | 1815 E. 19th St, The Dalles, OR 97058-9403 | 2011-03-31 |
| 1194975078 | Mid-columbia Medical Center | Obstetrics & Gynecology | 1730 E. 12th St, The Dalles, OR 97058 | 2008-09-26 |
| 1205804101 | Mid-columbia Medical Center | Home Health | 1730 E 12th St, The Dalles, OR 97058-3137 | 2006-03-08 |
| 1306842752 | Mid-columbia Medical Center | General Acute Care Hospital | 1700 E 19th St, The Dalles, OR 97058-3317 | 2005-06-21 |
| 1508427428 | Mid-columbia Medical Center | Clinic/Center | 33 Nichols Pkwy, Hood River, OR 97031-3121 | 2019-06-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MID-COLUMBIA MEDICAL CENTER | 1700 E 19th St, The Dalles, OR 97058 |
| Oregon Corporations, Companies and Business Names | MID-COLUMBIA MEDICAL CENTER AUXILIARY | 1700 E 19th St, The Dalles, OR 97058 |
| Street Address |
1620 E 12TH ST |
| City | THE DALLES |
| State | OR |
| Zip Code | 97058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176613 | Katherine Williams Omer | Pediatrics | 1620 E 12th St, Ste 200, The Dalles, OR 97058-3213 | 2005-07-05 |
| 1093215287 | Richard John Friday | Social Worker | 1620 E 12th St, The Dalles, OR 97058-3213 | 2018-02-14 |
| 1891245999 | Sean Mchugh | Physician Assistant | 1620 E 12th St, The Dalles, OR 97058-3213 | 2016-10-12 |
| 1881067809 | Rebecca Jane Hudson | Nurse Practitioner | 1620 E 12th St, The Dalles, OR 97058-3213 | 2015-11-13 |
| 1457737355 | Kim Whitaker | Family Medicine | 1620 E 12th St, The Dalles, OR 97058 | 2015-08-03 |
| 1982012324 | Jordan Joseph Nagle | Family Medicine | 1620 E 12th St, The Dalles, OR 97058-3213 | 2014-07-29 |
| 1821410531 | Coleen C. Moreno | Social Worker | 1620 E 12th St, The Dalles, OR 97058 | 2014-01-15 |
| 1487076154 | Jessica A Radley | Nurse Practitioner | 1620 E 12th St, The Dalles, OR 97058-3213 | 2014-01-14 |
| 1356607931 | Johanna Clara Nesse | Nurse Practitioner | 1620 E 12th St, The Dalles, OR 97058-3213 | 2012-04-08 |
| 1598072167 | Meghan Coats Mcallister | Nurse Practitioner | 1620 E 12th St, Columbia Hills Family Medicine, The Dalles, OR 97058-3213 | 2010-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646864 | Ashlee Kai Mcnamara | Behavior Technician | 2525 W 8th St., #34, The Dalles, OR 97058 | 2018-07-19 |
| 1548784689 | Mireya Moreno Ibarra | Behavior Technician | 401 East 3rd Street, Suite 101, The Dalles, OR 97058 | 2017-07-31 |
| 1407304991 | Joshua Seidel | Pharmacist | 515 Mt Hood St, The Dalles, OR 97058 | 2016-09-14 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1558731141 | Louise Goodnight | Case Manager/Care Coordinator | 419 East 7 Th Street, The Dalles, OR 97058 | 2015-09-25 |
| 1578944666 | Jessica Donnell | Dental Hygienist | 2529 E 12th St, The Dalles, OR 97058 | 2015-06-15 |
| 1487034328 | Savanna Schaan | Specialist | 609 W 14th St, The Dalles, OR 97058 | 2015-06-05 |
| 1801299102 | Mary E Zenorini | Social Worker | 1620 E. 12th St, The Dalles, OR 97058 | 2014-09-30 |
| 1669889143 | Diane Joan Irwin | Social Worker | 419 E 7th St #207, The Dalles, OR 97058 | 2014-07-17 |
| 1124452008 | Lacey A Nichols | Counselor | 312 E. Third St., The Dalles, OR 97058 | 2013-08-27 |
| Find all providers in zip 97058 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528383940 | Mid-columbia Medical Center | Clinic/Center | 1935 E 19th St, The Dalles, OR 97058-3392 | 2010-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183063 | Praxis Medical Group P.C. | Clinic/Center | 1890 7th St., Umatilla, OR 97882 | 2020-10-27 |
| 1336749621 | Praxis Medical Group P.C. | Clinic/Center | 2011 Fourth St., La Grande, OR 97850 | 2020-10-27 |
| 1225694706 | Columbia Lutheran Charities | Clinic/Center | 1111 N Roosevelt Dr Ste 210, Seaside, OR 97138-4604 | 2019-05-10 |
| 1093296519 | Grande Ronde Hospital, Inc. | Clinic/Center | 10303 S Walton Rd, La Grande, OR 97850 | 2018-08-23 |
| 1285164921 | Northwest Medical Foundation of Tillamook | Clinic/Center | 1005 Cougar St, Vernonia, OR 97064-1282 | 2017-06-15 |
| 1043694342 | Grande Ronde Hospital, Inc | Clinic/Center | 570 8th, Elgin, OR 97827 | 2015-07-16 |
| 1992183859 | Centennial Medical Group East, LLC | Clinic/Center | 145 E. Broadway, Myrtle Creek, OR 97457 | 2015-05-12 |
| 1477945517 | Morrow County Health District | Clinic/Center | 365 W 3rd St, Ione, OR 97843-7216 | 2015-02-26 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1487919783 | Aurora Family Health and Maternity Care Services LLC | Clinic/Center | 21358 Hwy 99e Ne, Aurora, OR 97002 | 2012-07-12 |
| Find all providers with the same taxonomy | ||||
| City | THE DALLES |
| Zip Code | 97058 |
Please comment or provide details below to improve the information on MID-COLUMBIA MEDICAL CENTER.
| 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.