# GORGE VALLEY MEDICINE, LLC

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

## Provider details

- **NPI number:** 1497319800
- **Authorized official:** DR. ANN M RUST MD (OWNER)
- **Authorized official phone:** (541) 965-9164

## Contact information

- **Practice address:** 1631 WOODS CT STE 103, HOOD RIVER, OR 97031-2916
- **Practice address phone:** (541) 346-3880
- **Mailing address:** 517 BROWNS RD, GOLDENDALE, WA 98620-2325
- **Mailing address phone:** (541) 965-9164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2019
- **Last updated:** 05/01/2019