Organization
CONFEDERATED TRIBES OF WARM SPRINGS RESERVATION OF OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHELE STACONA (SECRETARY/TREASURER-CEO)
(541) 553-3232
Entity
Organization
Contact information
Practice address
1270 KOT-NUM RD, WARM SPRINGS, OR 97761
(541) 553-1196
(541) 553-1347
Mailing address
PO BOX 1209, 1270 KOT-NUM ROAD, WARM SPRINGS, OR 97761-1209
(541) 553-2496
(541) 553-1347
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
Other
Enumeration date
08/02/2010
Last updated
02/01/2022
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