Organization
GRANDE RONDE HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY P DAVIS (PRESIDENT/CEO)
(541) 963-8421
Entity
Organization
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-3290
(541) 963-1472
(541) 963-1862
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-8421
(541) 963-1845
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
282NC0060X
Critical Access Hospital
Primary
140728
OR
282NC0060X
Critical Access Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067801
—
OR
Enumeration date
09/08/2005
Last updated
10/24/2025
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