Columbia Gorge Ent, LLC

NPI #1427056324 in The Dalles, Oregon

Provider Information

NPI Number: 1427056324
Entity Type: Organization
Organization Name: Columbia Gorge Ent, LLC
Primary Specialty: Otolaryngology
Enumeration Date: Jul 13, 2005
Last Updated: Aug 23, 2007

Practice Location

Address: 1815 E 19TH ST
Address 2: SUITE 1
City: The Dalles
State: Oregon
ZIP Code: 97058-3365
Phone: (541) 298-5563

Authorized Official

Name: DR. CHARLES R FORD, MD
Title: OWNER
Phone: (541) 298-5563

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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