| Organization Name: | UMATILLA MEDICAL CLINIC |
| NPI Number: | 1093834004 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEROY IRWIN MEHARRY (OWNER) |
| Mailing Address: | 1890 E 7th Street Umatilla |
| State: | OR US |
| Postal Code: | 978820790 |
| Phone Number: | 5419223104 |
| Fax Number: | 5419222951 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |