Healthcare Provider Details

I. General information

NPI: 1881057362
Provider Name (Legal Business Name): ZACHARY W SPOEHR-LABUTTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 SUNSET DR STE E
LA GRANDE OR
97850-1200
US

IV. Provider business mailing address

403 ALLIUM ST
LA GRANDE OR
97850-1201
US

V. Phone/Fax

Practice location:
  • Phone: 541-663-3150
  • Fax:
Mailing address:
  • Phone: 301-452-2189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD195855
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number681110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: