Organization
GRANDE RONDE HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MATTES (PRESIDENT CEO)
(541) 963-1454
Entity
Organization
Contact information
Practice address
300 E JEFFERSON ST STE 101, BOISE, ID 83712-6221
(208) 336-4141
(208) 336-4035
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-1555
(541) 963-1845
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
14-0728
OR
Other
Enumeration date
01/17/2007
Last updated
04/07/2011
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