Organization
GOOSE LAKE MEDICAL SERVICES INC
Active
Other names
Lake Health Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON DYBDAL (CEO/AUTHORIZED OFFICIAL)
(541) 947-7307
Entity
Organization
Contact information
Practice address
220 N E ST, LAKEVIEW, OR 97630-1407
(541) 947-2370
(541) 947-0929
Mailing address
220 N E ST, LAKEVIEW, OR 97630-1407
(541) 947-2114
(541) 947-2433
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
03/07/2016
Last updated
12/18/2025
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