Organization
CONFEDERATED TRIBES OF THE WARM SPRINGS RESERVATION OF OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE STACONA (SECRETARY-TREASURER/CEO)
(541) 553-3232
Entity
Organization
Contact information
Practice address
2124 WARM SPRINGS ST., WARM SPRINGS, OR 97761
(541) 777-2663
Mailing address
PO BOX C, WARM SPRINGS, OR 97761-3001
(541) 777-2663
(541) 777-2662
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
02/01/2022
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