Healthcare Provider Details

I. General information

NPI: 1427971332
Provider Name (Legal Business Name): GOOD SHEPHERD HEALTH CARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W ELM AVE STE 140
HERMISTON OR
97838-2713
US

IV. Provider business mailing address

610 NW 11TH ST
HERMISTON OR
97838-6601
US

V. Phone/Fax

Practice location:
  • Phone: 541-667-3661
  • Fax: 541-275-8796
Mailing address:
  • Phone: 541-667-3400
  • Fax: 541-667-3715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN EDWARDS
Title or Position: COO/CFO
Credential:
Phone: 541-667-3412