Healthcare Provider Details

I. General information

NPI: 1811072432
Provider Name (Legal Business Name): CONFEDERATED TRIBES OF THE UMATILLA INDIAN RESERVATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73382 CONFEDERATED WAY
PENDLETON OR
97801
US

IV. Provider business mailing address

46411 TIMINE WAY
PENDLETON OR
97801-9467
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-7676
  • Fax:
Mailing address:
  • Phone: 541-278-7676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number303306
License Number StateOR

VIII. Authorized Official

Name: JAMES HALL
Title or Position: FIRE CHIEF
Credential:
Phone: 541-276-2126