Organization
GRANDE RONDE HOSPITAL INC.
Active
Other names
Grande Ronde Hospital Womens Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MATTES (PRESIDENT)
(541) 963-1469
Entity
Organization
Contact information
Practice address
610 SUNSET DR, LA GRANDE, OR 97850-1248
(541) 963-2216
(541) 962-1042
Mailing address
610 SUNSET DR, LA GRANDE, OR 97850-1248
(541) 963-2216
(541) 962-1042
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
394792
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067801
—
OR
Enumeration date
06/12/2006
Last updated
11/08/2007
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