# CITY OF PENDLETON

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

## Provider details

- **NPI number:** 1982607016
- **Authorized official:** KAREN HOEFT (SR ACCOUNT CLERK)
- **Authorized official phone:** (541) 276-1442

## Contact information

- **Practice address:** 1455 SE COURT AVE, PENDLETON, OR 97801-3212
- **Practice address phone:** (541) 276-1442
- **Mailing address:** 911 SW COURT AVE, PENDLETON, OR 97801-1912
- **Mailing address phone:** (541) 276-1442
- **Mailing address fax:** (541) 276-9171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 3005-05 | OR | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 08/03/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 085387000 | BLUE CROSS | OR |
| 05 | — | 149393 | — | OR |
| 01 | — | 28045 | WASHINGTON LABOR AND INDU | OR |
| 01 | — | 590133278 | RAILROAD MEDICARE | OR |
| 05 | — | 8060348000 | — | OR |
| 01 | — | 9571407 | WASHINGTON MEDICAID | OR |