Organization
COLUMBIA GORGE MEDICAL CENTER PC
Active
Other names
Columbia Gorge Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER GRAY M.D. (MANAGING PARTNER)
(541) 386-5070
Entity
Organization
Contact information
Practice address
1750 12TH ST, HOOD RIVER, OR 97031-1513
(541) 386-5070
(541) 386-7190
Mailing address
1750 12TH ST, HOOD RIVER, OR 97031-1513
(541) 386-5070
(541) 386-7190
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176180
—
OR
01
—
198383
UNITED HEALTHCARE
—
05
—
7002678
—
WA
01
—
8901302
DEPT OF LABOR AND INDUSTR
WA
Enumeration date
12/07/2005
Last updated
02/16/2016
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