Healthcare Provider Details

I. General information

NPI: 1780880518
Provider Name (Legal Business Name): COMMONSPIRIT OREGON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 ST ANTHONY WAY
PENDLETON OR
97801-3836
US

IV. Provider business mailing address

2801 ST ANTHONY WAY
PENDLETON OR
97801-3800
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-8183
  • Fax: 541-278-6564
Mailing address:
  • Phone: 541-276-5121
  • Fax: 541-278-6564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number140034
License Number StateOR

VIII. Authorized Official

Name: JAMIE C POINDEXTER
Title or Position: MARKET VP OPERATIONAL FINANCE
Credential:
Phone: 541-677-2458