Healthcare Provider Details

I. General information

NPI: 1447884762
Provider Name (Legal Business Name): YELLOWHAWK TRIBAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 11/27/2023
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46314 TIMINE WAY
PENDLETON OR
97801-9417
US

IV. Provider business mailing address

PO BOX 160
PENDLETON OR
97801-0160
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-9830
  • Fax:
Mailing address:
  • Phone: 541-966-9830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA G HETTINGA
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 541-966-9830