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General NPI Number Information
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NPI Number | 1649115593
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Entity Type | Organization
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Legal Business Name | MATILDA HEALTH FOUNDATION
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 376 2ND AVE
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City | GOLD HILL
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State | OR
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Zip | 97525
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Country | US
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Telephone | 929-231-0673
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 UNION ST NE FL 7
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City | WASHINGTON
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State | DC
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Zip | 20002-7042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GREGORY ROCKSON
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Credential |
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Telephone | 929-231-0673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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