Healthcare Provider Details

I. General information

NPI: 1134368798
Provider Name (Legal Business Name): COMMONSPIRIT OREGON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 SE COURT AVE
PENDLETON OR
97801-3215
US

IV. Provider business mailing address

1416 SE COURT AVE
PENDLETON OR
97801-3215
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-4575
  • Fax: 541-578-4579
Mailing address:
  • Phone: 541-278-4575
  • Fax: 541-578-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMIE C POINDEXTER
Title or Position: MARKET CFO
Credential:
Phone: 541-677-2458