# CONFEDERATED TRIBES OF THE WARM SPRINGS RESERVATION OF OREGON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376199398
- **Authorized official:** MICHELE STACONA (SECRETARY-TREASURER/CEO)
- **Authorized official phone:** (541) 553-3232

## Contact information

- **Practice address:** 2124 WARM SPRINGS ST., WARM SPRINGS, OR 97761
- **Practice address phone:** (541) 777-2663
- **Mailing address:** PO BOX C, WARM SPRINGS, OR 97761-3001
- **Mailing address phone:** (541) 777-2663
- **Mailing address fax:** (541) 777-2662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2019
- **Last updated:** 02/01/2022