COLUMBIA RIVER HEALTH (NPI# 1710084140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710084140 |
| Entity Type | Organization |
| Organization Name | COLUMBIA RIVER HEALTH |
| Practice Address |
450 Tatone Street Boardman OR 97818 |
| Mailing Address |
Po Box 397 Boardman OR 97818 |
| Practice Telephone | 5414817212 |
| Practice Fax Number | 5414812020 |
| Mailing Telephone | 5414817212 |
| Mailing Fax Number | 5414812020 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-04-05 |
| Authorized Official Name | HIRAM S WHITMER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5414817212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 276286 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | COLUMBIA RIVER HEALTH | 450 Tatone St, Boardman, OR 97818 |
| Street Address |
450 TATONE STREET |
| City | BOARDMAN |
| State | OR |
| Zip Code | 97818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013900646 | Robert J Boss | Internal Medicine | 450 Tatone Street, Boardman, OR 97818 | 2005-08-30 |
| 1548320302 | David M Collins | Physician Assistant | 450 Tatone Street, Boardman, OR 97818 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178721 | Kaelyn Rose Lindsay | Counselor | 104 Sw Kinkade Ave., Boardman, OR 97818 | 2020-06-12 |
| 1225674807 | Jose James Ortiz Jr. | Counselor | 104 Kinkade Ave, Boardman, OR 97818 | 2019-11-19 |
| 1982149647 | Kymberli Dawn Erevia | Specialist | 104 S. W. Kinkade Road, Boardman, OR 97818 | 2017-01-04 |
| 1194277814 | Scott R Ruch | Community/Behavioral Health | 104 Sw. Kinkade Rd, Boardman, OR 97818 | 2016-10-28 |
| 1144660168 | Cydney M. Morgan | Counselor | 103 Sw Kinkade Rd., Boardman, OR 97818 | 2013-07-05 |
| 1801151121 | Mayra Colin Carrillo | Counselor | 104 S.w. Kinkade Rd., Boardman, OR 97818 | 2012-07-12 |
| 1306103429 | Good Shepherd Medical Service Corp | Pharmacy | 220 S. Main, Boardman, OR 97818 | 2012-04-13 |
| 1437359387 | Emily Dawn Reynolds | Counselor | 104 Sw Kinkade Road, Boardman, OR 97818 | 2007-07-19 |
| 1548485865 | Hayden Family Dentistry Group | Dentist | 300 Tatone, Boardman, OR 97818 | 2007-04-13 |
| 1336294057 | Brandi Nichole Pollick | Counselor | 101 Nw Boardman Ave, Boardman, OR 97818 | 2007-01-24 |
| Find all providers in zip 97818 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
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| 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.