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Active NPI 1013254432 Organization (Entity Type 2)

Pendleton Primary Care Clinic Llc

Clinic/Center - Primary Care • Pendleton, OR

About Pendleton Primary Care Clinic Llc NPI 1013254432 Summary

Pendleton Primary Care Clinic Llc is a verified healthcare organization specializing in Clinic/Center - Primary Care operating in Pendleton, OR. Located at 1100 SOUTHGATE STE 11, this facility provides patient care and medical services under National Provider Identifier (NPI) 1013254432.

Administrative operations and authorized compliance are overseen by Tami Foster (Office Manager).

Facility Location & Contact Primary Location

Facility Address

1100 Southgate Ste 11

Pendleton, OR 978013973

Telephone 5419666916

Fax 5412151405

Authorized Official Information

Authorized Contact Name

Tami Foster

Title / Role

Office Manager

Official Telephone

5419666916

Facility Classifications & Specialties

Clinic/Center - Primary Care Primary Taxonomy

NUCC Taxonomy Code: 261QP2300X

Definition to come...

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

10 Historical Events

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Updated Practice Location January 16, 2025

Registered at 1100 SOUTHGATE STE 11, PENDLETON, OR 978013973 (Tel: 5419666916)

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Updated Business Mailing Address January 16, 2025

Registered at 1100 SOUTHGATE STE 11, PENDLETON, OR 978013973 (Tel: 5419666916)

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Organization / Clinic Name Updated January 16, 2025

Operating as PENDLETON PRIMARY CARE CLINIC LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 16, 2025

Clinic/Center

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NPI Profile Active May 06, 2013

NPI status registered as active in NPPES database

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Updated Practice Location May 06, 2013

Registered at 1100 SOUTHGATE STE 9, PENDLETON, OR 978013940 (Tel: 5415671137)

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Updated Business Mailing Address May 06, 2013

Registered at 236 E NEWPORT AVE, HERMISTON, OR 978382449 (Tel: 5415671137)

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Organization / Clinic Name Updated May 06, 2013

Operating as PENDLETON PRIMARY CARE CLINIC

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 06, 2013

Clinic/Center (License #MD07786 in OR)

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Initial NPI Registration & Enumeration January 04, 2013

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1013254432

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: January 04, 2013

Last Update: January 16, 2025

Update or Correct Listing

Mailing Address

1100 Southgate Ste 11

Pendleton, OR 978013973

Phone: 5419666916

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.