MEDICARE: GORGE BONE DENSITY TESTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K285400	OTHER	OR	PACIFIC SOURCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295744365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GORGE BONE DENSITY TESTING LLC

Provider Business Mailing Address
First Line	:	1825 E 19TH ST
Second Line	:	SUITE 3
City	:	THE DALLES
State	:	OR
Zip	:	97058-3365
Country	:	US
Telephone Number	:	509-493-1467
Fax Number	:	509-493-3765

Provider Business Practice Location Address
First Line	:	1825 E 19TH ST
Second Line	:	SUITE 3
City	:	THE DALLES
State	:	OR
Zip	:	97058-3365
Country	:	US
Telephone Number	:	509-493-1467
Fax Number	:	509-493-3765

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CAROLANN J TATE
Credential	:
Telephone Number	:	509-493-1467

Provider Enumeration Date	:	08/06/2006
Last Update Date	:	09/06/2007

Similar Medicare Providers

1427056324 — COLUMBIA GORGE ENT, LLC
Practice Location Address:

1815 E 19TH ST , SUITE 1
THE DALLES, OR
97058-3365

Practice Phone: 541-298-5563
Practice Fax: 541-298-7746

1780693143 — DR. DOROTHY DELLA SHERWOOD M.D.
Practice Location Address:

1825 E 19TH ST
THE DALLES, OR
97058-3365

Practice Phone: 541-506-6940
Practice Fax: 541-296-2636

1518067339 — NATHAN F.E. ULLRICH M.D.
Practice Location Address:

1805 E 19TH ST
THE DALLES, OR
97058-3365

Practice Phone: 541-296-2201
Practice Fax: 541-296-1237

1992879514 — GARY A GINGRICH M.D.
Practice Location Address:

1805 E 19TH ST
THE DALLES, OR
97058-3365

Practice Phone: 541-296-2201
Practice Fax: 541-296-1237

1912063801 — RICHARD ALLEN GINGRICH MD
Practice Location Address:

1805 E 19TH ST
THE DALLES, OR
97058-3365

Practice Phone: 541-296-2201
Practice Fax: 541-296-1237

1790833721 — GORGE BONE DENSITY TESTING LLC
Practice Location Address:

1825 E 19TH ST , SUITE 3
THE DALLES, OR
97058-3365

Practice Phone: 509-493-1467
Practice Fax: 509-493-3765

Directions to “GORGE BONE DENSITY TESTING LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.