# GRANDE RONDE HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRANDE RONDE HOSPITAL SLEEP CLINIC -CALDWELL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194194902
- **Authorized official:** MR. JAMES A MATTES (PRESIDENT/CEO)
- **Authorized official phone:** (541) 963-1842

## Contact information

- **Practice address:** 1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
- **Practice address phone:** (208) 367-4817
- **Mailing address:** PO BOX 3290, LA GRANDE, OR 97850-7290
- **Mailing address phone:** (541) 963-8421
- **Mailing address fax:** (541) 963-1845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/22/2015
- **Last updated:** 09/22/2015