Healthcare Provider Details

I. General information

NPI: 1295789667
Provider Name (Legal Business Name): GOOD SHEPHERD HEALTH CARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 NW 11TH ST
HERMISTON OR
97838-6601
US

IV. Provider business mailing address

610 NW 11TH STREET
HERMISTON OR
97838-9696
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateOR

VIII. Authorized Official

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