NPIMap

Organization Active NPI

Columbia Gorge Radiology PC

  • Diagnostic Radiology Physician
  • The Dalles, OR
National Provider Identifier
1396820932
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD25785 Issued in OR
Legal business name
COLUMBIA GORGE RADIOLOGY PC
Practice address
1700 E 19TH St
The Dalles, OR 97058-3317
Phone
(541) 296-7251
NPI assigned
Oct 25, 2006
Last updated
Oct 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paula Maria Lee-Valkov, MDNPI 1558386045
Title
President
Phone
(509) 294-3758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X MD25785 OR Primary

Addresses

Primary practice location

1700 E 19TH St
The Dalles, OR 97058-3317

Mailing address

113 E 2ND St Ste B
The Dalles, OR 97058-1736
Phone (541) 298-8718

National Provider Directory

National Provider Directory

Locations

113 E 2nd St
Ste B
The Dalles, OR 97058

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1396820932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E 2ND ST STE B",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581736",
            "telephone_number": "541-298-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "541-296-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA GORGE RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "LEE-VALKOV",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-294-3758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD25785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.