Organization
CONFEDERATED TRIBES OF GRAND RONDE COMMUNITY OF OREGON
Active
Other names
Grand Ronde Health & Wellness Center Lab
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MORFIN (QUALITY ANALYST)
(503) 879-2060
Entity
Organization
Contact information
Practice address
9615 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2060
(503) 879-5089
Mailing address
9615 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2060
(503) 879-5089
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126883
—
OR
Enumeration date
10/05/2018
Last updated
10/05/2018
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