Organization
MID-COLUMBIA MEDICAL CENTER
Active
Other names
Adventist Health Columbia Gorge, Columbia Crest Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS KNOX (CORPORATE OFFICER CEO)
(541) 296-7273
Entity
Organization
Contact information
Practice address
1935 E 19TH ST, THE DALLES, OR 97058-3392
(541) 506-6520
Mailing address
PO BOX 1520, THE DALLES, OR 97058
(541) 506-6520
(541) 506-6516
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008485
—
WA
05
—
500628255
—
OR
05
—
500632165
—
OR
Enumeration date
03/29/2010
Last updated
06/19/2023
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