PENDLETON FAMILY PRACTICE AND SPORTS MEDICINE LLC NPI 1225538796

NPI Information

NPI: 1225538796
Provider Name: PENDLETON FAMILY PRACTICE AND SPORTS MEDICINE LLC

Former Legal Business Name: DR. KENT R. WALKER, D.O.

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
202 SE DORION AVE
PENDLETON, OR
ZIP 97801
Phone: (541) 966-8384
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PENDLETON FAMILY PRACTICE AND SPORTS MEDICINE LLC is a primary care clinic center in Pendleton, OR. PENDLETON FAMILY PRACTICE AND SPORTS MEDICINE LLC NPI is 1225538796. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Dr. Kent R. Walker, D.o..

The provider's business location address is:

202 SE DORION AVE
PENDLETON, OR
ZIP 97801-576
Phone: (541) 966-8384
Fax: (541) 966-8387

The provider's authorized official is Darla Linker .
The authorized official title is Office Manager and has the following contact phone number (541) 966-8384.

The enumeration date for this NPI number is 2/20/2018 and was last updated on 6/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		DO20295	OREGON	No
2	261QP2300X	Clinic/Center	Primary Care	DO20295	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	150117	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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