Organization
COLUMBIA RIVER HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJUANITA OLIVAS (REVENUE CYCLE DIRECTOR)
(541) 481-5448
Entity
Organization
Contact information
Practice address
450 TATONE STREET, BOARDMAN, OR 97818
(541) 481-7212
(541) 481-2020
Mailing address
PO BOX 397, BOARDMAN, OR 97818
(541) 481-7212
(541) 481-2020
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276286
—
OR
Enumeration date
09/20/2006
Last updated
10/24/2024
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