Columbia River Medical Clinic, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15400DO Issued in OR

Legal business name

COLUMBIA RIVER MEDICAL CLINIC, P.C.

Practice address

1615 E 12TH St
Suite 100
The Dalles, OR 97058-3212

Phone

(541) 296-1919

Fax

(541) 296-2253

NPI assigned

Sep 8, 2008

Organization subpart

No

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

Authorized official

Name

Mark Dennis Czarnecki, DO

Title

Owner

Phone

(541) 296-1919

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1659529287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1580",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588004",
            "telephone_number": "541-296-1919",
            "fax_number": "541-296-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 E 12TH ST",
            "address_2": "SUITE 100",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583212",
            "telephone_number": "541-296-1919",
            "fax_number": "541-296-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA RIVER MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "CZARNECKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-296-1919",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "15400DO",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Columbia Gorge Neurology Specialists, LLC
• Columbia Gorge Pathology Associates, LLP
• Columbia Gorge Radiology PC
• Columbia Gorge Surgery Center, LLC
• Columbia River Eye Clinic LLC
• Columbia River Radiology, PC
• Columbia River Women'S Clinic, LLC
• Columbiacare Services
• Columbiacare Services
• Bethany H Combelic

• Family Medicine Physician in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.