Organization
MID-COLUMBIA MEDICAL CENTER
Active
Other names
Gorge Urology, Adventist Health Columbia Gorge
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE KING (SERVICE AREA PRESIDENT)
(503) 261-4405
Entity
Organization
Contact information
Practice address
1805 E 19TH ST, THE DALLES, OR 97058-0000
(541) 296-2201
(541) 296-1237
Mailing address
PO BOX 1520, THE DALLES, OR 97058-0000
(541) 296-2201
(541) 296-1237
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008645
—
WA
05
—
500630716
—
OR
Enumeration date
07/16/2010
Last updated
04/14/2025
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