CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON


Address: 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712
Phone: 5038792236

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
OR 126883 05

Other Provider/Organization Names

Other Name Type Code
GR Health & Wellness Center Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 9605 GRAND RONDE RD
City GRAND RONDE
State OR
Zip Code 97347-9712

Providers in the same location

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
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Providers in the same zip code

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 Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

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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
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Competitor

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City GRAND RONDE
Zip Code 97347

Improve Information

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Dataset Information

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.

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