GRAND RONDE HEALTH AND WELLNESS CENTER
NPI 1174666358
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Grand Ronde, OR

Q: What is Confederated Tribes Of The Grand Ronde Community Of Oregon's specialty?

The primary specialty registered for this NPI is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy with taxonomy code 332800000X.

Active since February 15, 2007CLIA 38D0862855 · Certificate of Compliance

9605 GRAND RONDE RD, GRAND RONDE, OR 97347(503) 879-2236(503) 879-5089 Get Directions Write a Review

NPPES record last updated: February 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 7, 2022, Sep 21, 2021, Aug 23, 2021 and 2 more (5 updates tracked since 2019).

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About Grand Ronde Health And Wellness Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND RONDE HEALTH AND WELLNESS CENTER (NPI 1174666358) is a healthcare organization registered as an indian health service/tribal/urban indian health (i/t/u) pharmacy in Grand Ronde, Oregon and active in the NPI registry since February 2007. The organization holds a CLIA Certificate of Compliance certificate valid through December 18, 2027, maintains 2 additional practice locations, and lists Kelly D Rowe, Executive Director Health Services, as its authorized official.

NPPES Registry Identity

NPI1174666358

Entity TypeOrganization

Primary Taxonomy332800000X

Legal Business NameCONFEDERATED TRIBES OF THE GRAND RONDE COMMUNITY OF OREGON

Location Address9605 GRAND RONDE RDGrand Ronde, OR 97347-9712

Mailing AddressPo Box 338Grand Ronde, OR 97347-0338 · (503) 879-2236 · Fax (503) 879-5089

Phone(503) 879-2236

Fax(503) 879-5089

Organization SubpartNo

Authorized OfficialKelly D RoweExecutive Director Health Services · (503) 879-2075

Enumeration DateFebruary 15, 2007

Last NPPES UpdateFebruary 28, 20245 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2024

✔ NPI 1174666358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 14

★ Primary SpecialtyIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers

Taxonomy Code332800000X

Definition

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.

Also ListedCounselorTaxonomy 101Y00000X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedChiropractorTaxonomy 111N00000X

Also ListedDentist · General PracticeTaxonomy 1223G0001X

Also ListedOptometristTaxonomy 152W00000X

Also ListedGeneral PracticeTaxonomy 208D00000X

Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X

Also ListedClinic/Center · Federally Qualified Health Center (FQHC)Taxonomy 261QF0400X · License 126883 (OR)

Also ListedClinic/Center · RadiologyTaxonomy 261QR0200X · License 445142 (OR)

Also ListedClinical Medical LaboratoryTaxonomy 291U00000X · License 38D0862855 (OR)

Also ListedPharmacyTaxonomy 333600000X · License 1559 (OR)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

9605 GRAND RONDE RD, Grand Ronde, OR 97347

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Other Names 2

Other NameGrand Ronde Health And Wellness Center

Other NameGreat Circle Recovery

Secondary Practice Locations 2

Location 11011 Commercial St NE Ste 110Salem, OR 97301-1036 · Phone (503) 983-9900 · Fax (503) 983-9899

Location 23580 SE 82nd AvePortland, OR 97266-2902 · Phone (971) 339-9240

Other Identifiers 1

Medicaid500786332OR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Medica, Moda Health Plan, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 38D0862855

Grand Ronde Health & Wellness Center Lab · Grand Ronde, OR

Active · expires Dec 18, 2027

CLIA Number38D0862855

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateDecember 19, 2025

Certificate Expiration DateDecember 18, 2027

Laboratory DirectorKevin F. Foley

Laboratory Phone(503) 879-2167

Laboratory LocationGrand Ronde Health & Wellness Center Lab9605 Grand Ronde Rd, Grand Ronde, OR 97347

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI KATHLEEN HICINBOTHOM

Peer Specialist