Provider Demographics
NPI:1447884762
Name:YELLOWHAWK TRIBAL HEALTH CENTER
Entity type:Organization
Organization Name:YELLOWHAWK TRIBAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HETTINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-966-9830
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0160
Mailing Address - Country:US
Mailing Address - Phone:541-966-9830
Mailing Address - Fax:
Practice Address - Street 1:46314 TIMINE WAY
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9417
Practice Address - Country:US
Practice Address - Phone:541-966-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YELLOWHAWK TRIBAL HEALTH CENTER TTCM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management