| Organization Name: | PENDLETON PRIMARY CARE CLINIC |
| NPI Number: | 1013254432 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAMI J FOSTER (OFFICE MANAGER) |
| Mailing Address: | 1100 Southgate Ste 9 Pendleton |
| State: | OR US |
| Postal Code: | 978013940 |
| Phone Number: | 5415671137 |
| Fax Number: | 5415672336 |
| NPI Enumeration Date: | 01/04/2013 |
| NPI Last Update Date: | 05/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD07786 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |