CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON (NPI# 1174666358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174666358 |
Entity Type | Organization |
Organization Name | CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON |
Other Organization Name | GR HEALTH & WELLNESS CENTER |
Practice Address |
9605 Grand Ronde Rd Grand Ronde OR 97347-9712 |
Mailing Address |
Po Box 338 Grand Ronde OR 97347-0338 |
Practice Telephone | 5038792236 |
Practice Fax Number | 5038795089 |
Mailing Telephone | 5038792236 |
Mailing Fax Number | 5038795089 |
Enumeration Date | 2007-02-15 |
Last Update Date | 2019-03-19 |
Authorized Official Name | MR. CHRIS LENO (EXECUTIVE OFFICER) |
Authorized Official Telephone | 5038792340 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 261QR0200X |
Clinic/Center Specialization: Radiology |
445142 | OR | Ambulatory Health Care Facilities |
N | 291U00000X | Clinical Medical Laboratory | 38D0862855 | OR | Laboratories |
N | 333600000X | Pharmacy | 1559 | OR | Suppliers |
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
N | 111N00000X | Chiropractor | Chiropractic Providers | ||
N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
N | 133V00000X | Dietitian, Registered | 088 | OR | Dietary & Nutritional Service Providers |
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
126883 | OR | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 126883 | 05 |
Other Name | Type Code |
---|---|
GR Health & Wellness Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326513367 | Confederated Tribes of Grand Ronde Community of Oregon | Radiology | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2018-10-05 |
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 |
1104164359 | Confederated Tribes of Grand Ronde Community of Oregon Dba Gr Health & | Clinic/Center | 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2013-01-23 |
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 |
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 | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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---|---|---|---|---|
1215540398 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 102 Christian Avenue, Talent, OR 97540 | 2020-08-28 |
1790398048 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 307 Wagner Creek Road, Talent, OR 97540 | 2020-08-26 |
1922656289 | Clackamas County | Clinic/Center | 39831 Highway 26, Sandy, OR 97055-6558 | 2019-08-29 |
1063067312 | Virginia Garcia Memorial Health Center | Clinic/Center | 11300 Sw Hazelbrook Rd, Tualatin, OR 97062-6980 | 2019-08-05 |
1417411505 | Klamath Health Partnership, Inc | Clinic/Center | 2210 N Eldorado Ave Ste A, Klamath Falls, OR 97601-6418 | 2019-01-23 |
1679053946 | Siskiyou Community Health Center Inc | Clinic/Center | 830 Ne 9th St, Grants Pass, OR 97526-1626 | 2018-08-16 |
1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
1598284242 | Winding Waters Medical Clinic | Clinic/Center | 401b N Main St, Joseph, OR 97846-5030 | 2017-09-13 |
1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
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.
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.